Baby faq - all your baby care and pregnancy questions

Wearing an Infant or Smaller Child

2009-11-09T15:38:00.000-08:00

Infant Semi-recline

The infant semi-recline position allows the smaller baby to experience the world while giving him or her complete spinal support.

To place baby in this position:

Place sling on desired shoulder
Turn inside batting up against your chest
Hold baby in your arms with back of baby's head toward the rings
Place baby in sling in a semi-sitting position

NOTE: For the tiny newborn, you can fold a receiving blanket and place it inside the sling under the baby's torso so the baby can see out.

Horizontal position

The horizontal position lets your baby nurse or sleep in comfort. Smaller babies will fit curled up entirely within the sling. As your baby grows, his or her feet can hang out.

To place baby in this position:

Place sling on desired shoulder
Loosen tail to slack the sack
Turn inside batting up against your stomach,
even with the belt line
Hold baby in your arms in a horizontal position with the baby's head on the side opposite the rings
Place baby in sling laying down
Both of these positions can be used with the day-old newborn. They can also be used for the older baby; however, many older babies find these positions to be too confining and prefer other positions.

Remember, if you or your baby is uncomfortable, don't be afraid to shift either the baby or the sling until you are both happy. A baby in a properly fitted and adjusted sling should be comfortable and effortless to carry.

Wearing an Older Child

2009-11-08T15:32:00.000-08:00

(4 variations)

The Hip Carry

The Hip Carry: Useful and comfortable for babies 4-6 months to 2-3 years.

To place baby in this position:

Place sling on desired shoulder
straddle baby on your hip
place inside batting under baby's buttocks and thighs
Allow legs to hang out of sling
Tighten sling as snugly as possible
Top/outer batting can be pulled up to support baby's back or head if desired

The Back Carry or Papoose Carry.

The Back Carry: For the older child with excellent head/trunk control. Great for cooking, washing dishes!
To place baby in this position:

Place sling on desired shoulder
Rotate sling so shoulder pad is on your upper back and rings are on top of shoulder
Place baby as if for hip carry position
Rotate baby and sling until pad and rings are in their proper positions. Baby will be sitting behind your hip

The Kangaroo Carry

The Kangaroo Carry: Excellent for the curious baby.

To place baby in this position:

Place sling on desired shoulder
Turn inside batting up against your stomach
Hold baby in your arms, facing out in an "indian style" position
Place baby sitting in the pouch, crossing his or her legs

Note--the younger baby with less trunk control will tend to "list" to the side opposite the rings. If your young baby likes this position, keep a hand on his or her trunk.

The Belly Carry

The Belly Carry: Cozy and secure, great for walks--baby can nap with his or her head nestled against you.

To place a baby in this position:

Place sling on desired shoulder Hold baby in your arms, facing you Place baby in the sling against your stomach/chest with the inside batting supporting his or her bottom Younger babies' legs will curl up in the sack, older babies' legs will hang out of sling

Midlife Pregnancy

2009-11-08T15:27:00.000-08:00

Being informed on the path to parenting:
The first thing you need to do to become a midlife mommie is to get pregnant .
Unfortunately as women get older infertility can become a problem.
Ectopic pregnancy is more common in women over the age of forty.
The rate of miscarriage is higher for older women, seek support if you need it.
Genetic testing testing can ease the fears. of not having a normal child.
Finding out the sex makes it easier to plan ahead.
More cesearean sections sections are performed on older moms.

Infertility and You

Infertility can be a touchy subject for women trying to conceive.
According to a national organization on infertility called Resolve," Infertility is a disease or condition of the reproductive system often diagnosed after a couple has had one year of unprotected, well-timed intercourse, or if the woman has been unable to carry a pregnancy that results in a live birth".

Many couples have a hard time admitting they might have an infertility problem. Infertility is nobody's fault, but some people are more prone to having problems conceiving than others.

Most gynecologists will want you to try for around a year before testing, but if you have had trouble with your periods or your partner has a low sperm count you might want to seek help sooner.

It's helpful to remember that you are not alone, 20% of children are now born to women over the age of thiry five. Seek the support of women who have had fertility problems and use their advice.

Ectopic Pregnancy..What is it?

An ectopic pregnancy happens when you conceive but the fertilized egg implants itself somewhere other than the uterus . Around 95% of the time the misplaced implantation occurs in the fallopian tube, usually due to scar tissue from previous pelvic infections.

The major health risks from ectopic pregnancy come from internal bleeding. Before detection methods improved, many women died from an ectopic pregnancy.

If you are in the early stages of pregnancy, look for bleeding, dizziness, or pelvic pain as symptons to be concerned about. This is serious stuff and can prevent your chances of having a healthy pregnancy later on.

Miscarriage..feeling the loss

Finally making it to the pregnancy stage and having it end in a miscarriage is tragic loss. The risks for miscarriage increase with age. Women between the ages of 35 -44 have a 21% chance of miscarriage. That jumps to 50% over the age of 45.

There are various newsgroups and mailing lists on the internet that offer support for those who have gone through a miscarriage.

Genetic Testing

Women over the age of thirty-five have an increased chance of carrying a fetus with chromosomal abnormalities. Genetic testing can help ease some of the fears that older women have when they get pregnant.
The two most commonly performed tests are anmioncentesis and CVS. Anmio is usually performed 14-16 weeks into the pregnancy and takes about three weeks to get the results.

CVS can be performed earlier, 10-11 weeks into the pregnancy but has a slightly higher risk of miscarriage.

What Does It Show

Genetic tests can help determine if there are specific genetic problems in the fetus. The most common is Down 's syndrome, but tests for Tay-Sachs disease,cystic fibrosis and sickle cell anemia can be performed if their is a family history of these conditions.

An added benefit is the ability to find out the sex of your baby. Some parents choose not to take this option and wait for the birth.

It can make it easier to plan ahead and tell people what to get you for gifts.

Having a C Section

Statistics show more cesearean section deliveries are performed on older moms. The main drawback is a longer hospital stay and recovery time than with a vaginal birth. It can however be a lifesaving procedure for both the mother and infant.

C sections are generally performed when the baby is breech (feet first) or the mother has other health complications. Many women feel disappointed if they are unable to have "natural childbirth" or at least a vaginal birth.

The miracle remains the same..nurturing a life inside your body and bringing someone into the world, is cause for celebration, regardless of which route you take.

Ready to Be a Mom?

2009-11-08T15:21:00.000-08:00

Take our quiz and find out!!

1. How does your baby lust rank amongst your peers?

a. When you say the word 'baby' to your friends, they either think you're talking about a boyfriend or they flip their hair back and look at you with a blank, uncomprehending stare.

b. Every week another baby announcement from a friend arrives in the mailbox, and you're beginning to feel like you're the only one still menstruating.

c. All of your friends have children over 5, and your nickname has become "Auntie."

2. How will a baby fit in with your career?

a. What do you mean? Don't most people just hire a nanny and get on with life?

b. Well, it's going to be a bit of a mess, but I want a baby so badly that I'm willing to forge ahead, somehow.

c. Career Shuh-meer! Who cares about work when you have a chubby, perfect, sweet little baby in your arms? Give me booties over paychecks, any day.

d. I don't know what the heck I'm doing with my life so I might as well have a baby.

3. How will a baby fit in with your relationship or marriage?

a. One of you is ticking loudly with the biological clock while the other goes to bed wearing ear plugs.

b. "Of course we want to have kids!" you say, but realistically starting a family is always "two years from now."

c. You've already decorated the nursery and now you're plotting out your ovulation together and deciding when to schedule that romantic evening in bed.

d. Babies? You never really discussed them much until you missed your period last month.

e. You are secretly hoping that a baby might make the two of you fall in love all over again.

4. How will a baby affect YOU?

a. You are sick of being focused on yourself and look forward to the fresh perspective that a child can bring into your life.

b. If you have to get less than 9 hours of sleep a night, you'll die.

c. You don't think having a baby is any big deal -- just strap it on your back and go shopping as usual!

d. You can't imagine YOU as a mother. Your life is going to be totally different, and you are both terrified and excited about it. This is a real rite of passage!

5. How comfortable are you around babes and tots?

a. When someone hands you a baby to hold, you blush and go all rigid, afraid that you'll drop it.

b. You start sweating whenever a toddler starts talking to you because they are so unpredictable ("You're a poo-poo head!") and because you really don't want those grubby little hands on your dry-clean-only slacks.

c. You find most babies ugly and uninteresting and wonder if something weird is going to happen to you when you hold your own for the first time.

d. You immediately get down on the floor, grab a rattle, and get all googly.

e. You're a natural with your friends' babies -- until they start howling and you hand them over with relief to their Moms.

6. How up-to-date is your parenting IQ?

a. You think that "attachment parenting" is for monkeys.

b. You think someone would be half-crazy to read a whole book about the "Ferber technique" when it comes to putting kids to bed. You'll just walk in, read them a story, shut out the light, kiss their little cheeks, and walk out, right?

c. You have never heard of inverted nipples and aren't sure you want to find out any more, thank you.

d. You don't know all the words to Barney's theme song yet.

7. Are you prepared for what Pregnancy will do to your body?

a. If you're careful, you'll only gain about 20 pounds.

b. If you're careful, you'll only gain about 20 pounds.

c. If you're careful, you'll only gain about 20 pounds.

d. If you're careful, you'll only gain about 20 pounds.

8. When it comes to imagining yourself as a parent,

a. You see yourself smiling, rocking in a chair with your clean and swaddled baby while the grandfather clock ticks in your clean and well-ordered home and the sunshine pools at your clean feet and homemade bread bakes in the clean oven and the cat purrs... just like they show in those pretty parenting magazines.

b. You know you'll be better at it than all of your friends, especially the ones whose kids have those incredibly out-of-control, humiliating, belly-on-the-floor tantrums in the supermarket aisle.

c. You're sure that you'll never yell those stupid things that your own Mom used to, like "Because I said so!" or "Listen here, young lady!"

d. You vow to allow only aesthetically-pleasing wooden toys into the house. Your living room floor will NEVER be littered with fluorescent plastic pop beads, naked Barbies, and grinning nylon clowns.

Click here to get the answers to the quiz!

Natural Gender Selection

2009-11-07T15:17:00.000-08:00

So you have two boys and are looking for a girl to cuddle. Maybe you have three girls and are looking for a bit of testosterone in the house to even things out. Perhaps the idea of the "balanced" family appeals to you: one girl, one boy. Whatever the reason, the idea of choosing the gender of your next child can be appealing.

Some couples choose the scientific route: gender selection done in a lab by separating the male and female sperm, sorting them by the weight of the DNA. This new technique offers an 85 percent chance of conceiving a girl and a 65 percent chance of conceiving a boy. Ethical and cost considerations generally lead couples who want to have some influence over the gender of their future child to more natural, less high-tech solutions.

Natural gender selection requires an understanding of a woman's fertility cycles. Unlike a man, who is fertile every day of his life once he reaches puberty, a woman is fertile for only a few days of her cycle, or roughly 20 percent of the time. Because a woman can only get pregnant when she is fertile, it takes a bit of knowledge about the woman's cycle to help choose the gender of the child.

To determine when she ovulates, a woman can chart her basal body temperature, chart her cervical fluid, use ovulation predictor kits, or any combination of the three. Statistically, most women ovulate mid-cycle, about 12 to 16 days before menstruating.

The trick to gender selection is learning about sperm. Male sperm (or Y chromosome-carrying sperm cells) are generally faster, but the downside is that they tend to die more quickly than female sperm (X chromosome-carrying sperm cells). Some researchers theorize this is because the male sperm burns out before the female sperm; others believe that the vaginal/cervical environment is hostile to male sperm.

If you want to try for a girl, have relations as soon as a woman's body signals that she is fertile. Have intercourse every night until two days prior to ovulation. This gives time for the male sperm to die off, but still leaves plenty of the female sperm behind when the egg arrives.

To try for a boy, have intercourse the day before and the day that you ovulate. This ensures that the faster male sperm are still around in greater quantities when the egg is released, giving them better odds of reaching the egg first.

Of course, no method is foolproof (even in the lab, they miss by 15 to 35 percent), so try to go into your experiment with the idea that no matter what your child's gender, you'll love it. When all is said and done, all that matters is a healthy baby.

Sexual Diseases & Fertility

2009-11-07T15:15:00.000-08:00

Sexually transmitted diseases (STDs) are not often discussed in the context of one of their possible consequences: infertility. Great societal stigma has been assigned to these various infectious diseases which are transmitted primarily through sexual or blood contact. Because of this stigma, many women may actually go throughout their lives never knowing they have contracted such a disease until it is too late.

The rapid, epidemic transmission of genital herpes a few decades ago had one positive result -- many people learned that even "nice, clean" people can be infected by an STD. I refer to this as positive because those people then, hopefully, learned about their bodies and took the necessary precautions to avoid further transmission, rather than continuing to look the other way and live in denial of their infection. Unfortunately, however, this more open way of dealing with STDs came to a standstill yet again with the advance of HIV. Now, many are coming to terms with the trademark slogan of HIV activists: "Silence equals death."

For many who have come into contact with an STD, and particularly those who do not yet know that they have been infected, silence may equal infertility and other debilitating health effects. Depending on the specific disease, the amount of time between initial infection and treatment, and the overall health of the infected individual, diseases such as chlamydia, gonorrhea, syphilis, human papilloma virus, herpes simplex, hepatitis B, and others can permanently alter one's life in sometimes dramatic and tragic ways.

What can be done? First, we must continue to fight the senseless stigma which these diseases carry. If you think that you are unaffected by such societal forces, ask yourself "would I feel as comfortable asking my doctor for a chlamydia test as I do asking for a strep throat culture?" Many health practitioners, unfortunately, still maintain that only certain high-risk groups of people, those who have certain lifestyles or behaviors, warrant screening for STDs. What this means is that many of you who are reading this have never been approached by your doctor or midwife about being tested.

Any woman who is trying to conceive should ask her practitioner for a screen of the major STDs, optimally prior to conception. Women (and men) who are experiencing difficulty conceiving should consider STD screening a routine part of their diagnostic period. Practitioners would do well to avoid some of those discomforting questions about you and your partner's sexual pasts by simply running the same tests on every patient, regardless of socioeconomic status, other demographics, and perception.

Last, and perhaps most importantly, teach your children about STDs. Be an advocate for education. Wouldn't it be grand to be able to say that we've sent some STDs the way of the eradicated smallpox? It can only happen through frank and open discussion.

Am I Pregnant?

2009-11-07T15:12:00.000-08:00

Early Signs of Pregnancy

Feeling queasy? You could be pregnant. The following symptoms are common signs that conception has taken place. Not all Mothers experience the complete list of symptoms. In fact, many of these symptoms can be caused by things other than pregnancy. Please consult with your healthcare provider if you feel you are pregnant. Prenatal care is vital to a healthy and safe pregnancy.

Tender or Swollen Breasts -- Starts 1-2 weeks after conception.

Sleepiness or Exhaustion -- Starts 1-8 weeks after conception.

Darkening of Areola (Nipple Area) -- Starts 1-12 weeks after conception.

Lack of Menstruation -- Evident from week 4 onward.

Food Cravings -- Can start as early as week 1.

Backache -- Can start as early as week 1.

Headache -- Can start as early as week 1.

Parenting at a later age

2009-11-06T15:11:00.000-08:00

Raising kids, despite its many rewards, can be an exhausting, seemingly endless job. It's enough to give anyone gray hair. But imagine starting a family at an age when you might already have gray hair, at 40, 45, or 50? Many couples today are having babies later in life and face some unique challenges.
Why many couples are waitingl

The birth rate among women older than 40 has increased by nearly half in the last 20 years. Why? Many couples have chosen to establish their careers before having children or simply didn't feel ready for the responsibility. Others didn't marry until later in life or had children from an early marriage, divorced and then started a second family with a new partner. Also, improvement in treatments for infertility and the fact that most women over 40 are in excellent health have helped make middle-age parenting a greater possibility.
Should you wait?

It's likely that older parents may be wiser, more mature and have greater patience. They may be better focused, having achieved a lot in their careers and feel ready for the "next phase." They may be more stable financially and may have more flexibility in their careers that allow being home to parent. And one could argue that just having lived longer, older parents may have a healthier perspective on life and better coping skills to aid them in their parenting.

But on the other hand, they may have less energy than their younger counterparts. And, if older couples have spent decades establishing careers and are accustomed to structure and predictability in their lives, they may have more trouble adjusting to the unpredictable nature of children. Some may consider the normal frustrations of child-rearing as reflections of their inability (in their opinion) to be "successful" parents. Then there are the obvious concerns of living to see their children reach adulthood.
Some tips for older parents

It seems, then, that the advantages and disadvantages in later-age parenting aren't clear-cut and vary depending on whom you ask. "In the end, no matter what you're age, your ability to parent really comes down to you as an individual — your maturity, personality and values," emphasizes Arla J. Bernard, R.N., parent education coordinator at Mayo Clinic, Rochester, Minn. Bernard offers this advice for middle-age parents:

Ask yourself some tough questions — Before you decide a new baby is right for you, ask yourself if you are emotionally and physically strong enough to handle raising a child?

Have realistic expectations — Babies mean change. Be prepared for what may be a great adjustment in your lifestyle. Ask yourself how a baby would fit into your current lifestyle, and how flexible could you be?

Pediatrician William J. Barbaresi, M.D., echoes Bernard's concern. "Be prepared that, no matter how much reading or preparing you do, you can't control or predict every aspect of your child's development."

Seek out a support system— Older couples may have less support from extended family because their own parents are even older (or may no longer be living). Meanwhile, many of their friends may already have raised their children. If you have other responsibilities — older children, parents or relatives to care for, a business to run — you may have even more reason to seek support from others going through similar phases in life. Seek out people who are willing to listen as well as offer advice.

Exercise, eat right, and take time for yourself— As you age, your body's ability to bounce back after being up all night with a child or working all day and then coming home to parent may change. It's important to balance good nutrition with aerobic activity to increase your energy level while maintaining good health. "Also it's important for parents who may feel overwhelmed with their new responsibilities to set aside some time just for themselves and for their relationship," notes Laura T. Evans, co-founder of the National Parents Association in Val Paraiso, Ind., a volunteer organization that provides support and information for parents.

Make long-term financial plans — It's very possible you may be in your retirement years at the same time you have the greatest expenses of raising a child. By planning ahead, you may provide a more secure future for your family.

Be prepared for other people's reactions— When a 63-year-old woman recently gave birth for the first time, it received a lot of attention. People generally have children when they are in their 20s and 30s. That's considered the "ideal." And while people may be more accepting of older men having children, they may not feel the same about older women. You may face sex and age discrimination and being prepared with a straight-forward but non-defensive response may make things easier.

Challenging society's notions of the ideal parent

Bernard points out that advice she gives to middle- and later-age parents is really no different from what she gives to younger parents, and that there is no guarantee any parent will live to see his or her child into adulthood. And she reminds parents that once the baby arrives — despite any reservations they might have once had — they probably won't be able to imagine what their life was like before their new child.

She challenges friends and families of later-age parents to be accepting, empathetic and supportive. "As we see more and more nontraditional families, it's important that society as a whole begin to challenge the notion of the 'ideal parent'," Bernard says. She adds: "Parenting at 20, 40, or even later takes the same basic things: nurturing love — and a sense of humor."

10 Reasons to Have a Midlife Baby

2009-11-06T15:10:00.000-08:00

10. You've had lots of practice raising a child, or if childless, you've had lots of time to
prepare.

9. You're set financially.

8. You've learned patience and a good sense of humor.

7. You've seen what's happened to your friends your age with their empty nest syndrome.

6. You feel too young to be a grandmother.

5. You don't really want to buy that mid-life crisis sports car.

4. You enjoy playing Easter bunny, Santa Claus, making Halloween costumes.

3. You don't have time to worry about how long you have to wait to join AARP at the age of 50.

2. You don't plan to enter the next Summer Olympics in the "Hot Flash" event.

1. You're so busy enjoying life and your children that you don't have time for a mid-life crisis.

Smoking and pregnancy

2009-11-06T15:07:00.000-08:00

If you think that smoking is not addictive, that cigarettes are a good way to control your weight, and that cigarettes really aren't such a bad habit, we've got news for you.

Women have become addicted to cigarettes over the years, and the tobacco industry has become addicted to women. The industry has spent billions of dollars to get women hooked on one of the most destructive substances in existence.

Cigarette smoking claims the lives of 430,000 Americans each year. Approximately 152,000 are women.

Christy Turlington, a former smoker and one who lost her father to lung cancer, joins the Centers for Disease Control and Prevention (CDC) in a video presentation that takes us inside the tobacco industry and gives us a good look at the myths that cigarette manufacturers use to target women.

Smoking increases a woman's risk of heart disease, stroke, and many forms of cancer. Smoking reduces fertility, increases the risk of pregnancy complications like premature birth and low birth weight, and leads to an earlier menopause.

Know what you really need to know about cigarette smoking and the tobacco industry.

Ten steps to a healthier pregnancy

2009-11-05T15:04:00.000-08:00

WHAT ALL PREGNANT WOMEN SHOULD KNOW ABOUT FITNESS AND NUTRITION

1. Don't stop eating or start skipping meals as your weight increases. Both you and your baby need the calories and nutrition you receive from a healthy diet.

2. Talk with your doctor before starting an exercise program during pregnancy. If you have been exercising, cut back your level of exercise to no more than 80 percent of your prepregnancy level.

3. Stomach upset and morning sickness are common during pregnancy. Some foods you normally love may make you feel sick to your stomach. You may need to substitute other nutritious foods you tolerate better. Likewise, overeating or eating too close to bedtime often causes heartburn. Eating five or six small, nutritious meals a day instead of three large ones may make you feel better.

4. Fish can be a healthful food choice during pregnancy, but don't eat shark, swordfish, king mackerel or tilefish. Click here to find out why.

5. A good way to add calcium to your diet is to cook rice and oatmeal in nonfat milk instead of water. Oatmeal is a great tummy soother too!

6. Drink extra fluids (water is best) throughout pregnancy to help your body keep up with the increases in your blood volume. You'll know you're drinking enough fluid when your urine looks like almost-clear water.

7. Prevent listeriosis, a food-borne illness that could be detrimental to unborn babies, by thoroughly cleaning and cooking all food, and watching out for undercooked or unrefrigerated meats and unpasteurized dairy products which might be contaminated.

8. When cutting down on caffeine during pregnancy, read labels. More than 200 common foods, beverages and over-the-counter medications contain caffeine!

9. Your need for additional calories and certain nutrients such as calcium and vitamin D increase if you are carrying twins. Depending on your pre-pregnancy weight, it is estimated that you need to eat about 150 calories more a day when pregnant with twins then when carrying only one baby. Share stories with other new moms of twins here.

10. During exercise, your oxygen demands increase. Your body is heavier, and your balance may change. You may also tire more easily. Keep these points in mind as you adjust your fitness program.

Beer and breastfeeding

2009-11-05T15:00:00.000-08:00

I just had my first baby, Chloe, and am breastfeeding. My mom says that when she was nursing me, her doctor told her to have a beer every night! I'd love to have a glass of wine, but really don't want to be sharing it with my baby! What do you think?

Your mom is not alone; many women have heard the same thing. They are told that a beer or a glass of wine will help establish their milk supply and keep it flowing. I'm not aware of any scientific studies which have addressed this issue, but alcohol is known to release inhibitions and helps some people relax. It's important to be calm and relaxed while nursing. In fact, most women find that they have trouble nursing when they are tense or in a stressful environment -- it's hard for the milk to get down.

Does this mean that it's a good idea? Well, not necessarily. A small amount of alcohol does get into breast milk, about one percent on average. While many consider this amount harmless, the best way to avoid giving your baby alcohol is to "pump and dump"; after having a glass of wine or other alcoholic beverage, express your milk at the next feeding and discard it. It's fine to resume nursing with the following feeding.

Woman's child-bearing years

2009-11-05T14:58:00.001-08:00

What are a woman's child-bearing years and how late can you wait to get pregnant?

A woman's child-bearing years are those years when a woman is able to become pregnant. This period of fertility generally spans from adolescence to menopause. In the past five years, however, we have seen the upper age limit pushed higher and higher as women use assisted methods of reproduction. In these cases, postmenopausal women have carried pregnancies to term using eggs donated by younger women. The ability to conceive decreases with age, while the likelihood of having an abnormal pregnancy increases with age.

There never seems to be a "perfect" time to get pregnant. Somehow, most people just know when it seems right. It's best to start before age 35 whenever possible to avoid the significant fall in fertility that occurs at age 40. On the other hand, some women don't even consider pregnancy until well into their 40's, after they have established their careers and have the financial means to support a family.

Only you know what's best for you. But keep in mind that the older you are, the harder it is to conceive. Even assisted reproduction, such as in-vitro fertilization (IVF), is less successful after age 40. As a result, more and more women are using eggs donated by younger women to become pregnant through IVF.

Stay well!

Don't have early symptoms of pragnancy?

2009-11-04T14:55:00.000-08:00

I'm nearly four weeks pregnant and am not experiencing the early symptoms I've been reading about: breast swelling and tenderness, nausea, and so on. Should I be concerned?

You're right that the symptoms of early pregnancy include breast swelling, nipple tenderness, nausea, and fatigue. While the onset of these symptoms is highly variable, most women notice them earlier with their first pregnancy, typically starting four weeks after conception. If you have already had one or more children, especially if you breast-fed them, then you probably will not experience the breast-related symptoms at this point in your pregnancy.

I understand that you are concerned by the lack of symptoms. You probably know someone who felt great until she found out that all was not well with the pregnancy. Keep in mind that while mishaps do occur, the odds are in your favor that this is a healthy pregnancy and you should approach it as such. Look at this as a blessing and enjoy the fact that you feel so well. Remember, it probably won't last; you will probably be miserable soon enough and just wishing you could feel normal again!

Wishing you health,

Ectopic pregnancy

2009-11-04T14:54:00.000-08:00

My roommate was just diagnosed with an ectopic pregnancy. I always thought this was a very serious medical emergency that needed surgery, but she was treated with just a shot. Can you help clear this up? Does she really have an ectopic pregnancy?

Ectopic pregnancy is a serious medical problem that is thought to occur in about 2 percent of pregnancies. An ectopic refers to any pregnancy which implants outside of the uterine cavity. While almost all ectopics occur in the fallopian tube (98 percent), they also implant on the ovary, inside the abdominal cavity or within the cervix. Surgery is no longer the only option. Early detection makes it possible for some women to be treated with medication instead of surgery.

A history of pelvic inflammatory disease (PID), especially chlamydia, is the single most important risk factor. Smoking, history of tubal surgery or a previous ectopic, DES (diethylstilbestrol) exposure or IUD use also increase risk. Certain fertility techniques increase the risk of ectopic pregnancy such as in vitro fertilization, GIFT (gamete intra-fallopian transfer), even ovulation induction. However, most ectopic pregnancies occur in women with no apparent risk factors.

The classic warning signs of an ectopic are a late period, vaginal spotting or bleeding, and abdominal pain. In most cases not all three symptoms are present, making the diagnosis more difficult. As an ectopic pregnancy develops, it may grow large enough to tear or rupture the fallopian tube causing internal bleeding and a potentially life-threatening situation. Diagnosing an ectopic pregnancy early is key to avoiding complications. Today, 80 percent of ectopic pregnancies are treated before rupture of the fallopian tube.

The diagnosis is made using a very sensitive pregnancy test (immunoassay for human chorionic gonadotropin, or HCG), ultrasonography, and, if needed, laparoscopy. In a healthy pregnancy, HCG levels rise in a fairly predictable manner. Levels that do not rise appropriately can signal a pregnancy at risk. A progesterone blood test may also be used as an indicator of a healthy pregnancy. Ultrasound is used to locate the pregnancy or look for signs of a potential problem like swelling in a fallopian tube.

Treatment must be tailored to the individual. In some situations, emergency surgery is required to control internal bleeding. When the diagnosis is made early, prior to tubal rupture and the patient is clinically stable, treatment options include surgery or medical management what you referred to as "the shot".

Methotrexate was first used to treat an ectopic pregnancy in 1982 in Japan and has been used in the United States since 1986. But it's not for everyone. Methotrexate is given as one or two shots depending on the size of the patient and the length of pregnancy. HCG levels are followed closely to be sure the pregnancy is resolving. It takes about four weeks for HCG levels to fall to zero. Some women have side effects from the medication such as soreness in the mouth, stomach upset or diarrhea. Methotrexate can also affect liver metabolism, so women who have been treated need to avoid alcohol and folic acid. Methotrexate works about 85 percent of the time, sometimes a second injection is needed. Close follow-up is essential because treatment failures require surgery to remove the ectopic pregnancy.

Methotrexate is less expensive than surgery and since it's less traumatic to the tissues, it can be better for future fertility. While this is a reasonable option in many cases, it's not right for everyone. Some women prefer the "quick-fix" of surgery rather than the month-long process with medication. I hope you find this information helpful. It sounds as if your roommate received excellent, state-of-the-art medical care. I hope that her course proceeds smoothly.

What is causing me to drool during pregnancy?

2009-11-04T14:52:00.000-08:00

I'm three months pregnant and have a terrible problem: I'm drooling all the time. It's embarrassing. I can't go anywhere without a towel to soak up my saliva. What's wrong with me?

You're suffering from a condition known as ptyalism, copious saliva production. Many women find this annoying in pregnancy, but it can also be distressing and may affect your health. Ptyalism was thought to occur in 1 percent of pregnancies, but a recent report from the University of Wisconsin at Madison found one in six women noticed excess saliva during pregnancy (presented by Maureen Van Dinter, N.P. at the 2001 conference of the World Organization of Family Doctors).

Ptyalism usually begins in the first trimester, and most women who experience it find the volume of saliva doubles. It may be milky, thick or bubbly. The saliva is often bitter and can lead to nausea, vomiting or even weight loss. Besides the increased saliva, women with ptyalism often have a coated or thickened tongues or distended cheeks from swollen salivary glands. It can affect the sense of taste or interfere with swallowing. Nearly one-third of women in the study said it disrupted their sleep and 27 percent said it affected their speech.

While it's not clear what triggers ptyalism, diet seems to play a large role. Many women find dairy products make their symptoms worse. For others the culprit is starchy foods. The first step in treatment is making changes in your diet to help reduce symptoms. Most women find that eating fruit can do a lot for alleviating symptoms. Sucking on hard candy or using mouthwash can also help by disguising the bad taste of the saliva. There can also be an emotional component to the problem, and counseling may help.

Be sure to let your doctor know about this problem so you can work together toward a solution.

Wishing you health,

Is it safe to continue exercising through pregnancy?

2009-11-03T14:51:00.000-08:00

I'm three months pregnant, and my husband and I are debating whether or not it's wise for me to keep jogging. I've been running for the past ten years and want to keep it up now that I'm pregnant. He's afraid it's bad for our baby and bad for me. What do you think?

Times have certainly changed. In the past we discouraged women from having any physical activity during pregnancy -- we feared it might rob precious blood flow from the uterus and baby. Today, exercise is considered part of a healthy lifestyle and part of a healthy pregnancy. Women who have normal, uncomplicated pregnancies are encouraged to stay active. In fact, a recent study found that women who exercised regularly beginning early in pregnancy had slightly bigger babies and slightly larger placentas, and experienced no harm at all (Clapp, J.F. Beginning regular exercise in early pregnancy: Effect on fetoplacental growth. Am J Obstet Gynecol 2000;183:1484-1488).

Exercise will improve your mood, help you sleep better and feel better. It can ease some of the aches and pains of pregnancy, like constipation, leg cramps, bloating and swelling. Exercise builds strength and stamina to prepare you for the hard work of labor and delivery -- which can be like running half a marathon! It won't guarantee a painless delivery, but it can help ease the process and speed recovery.

But it can be tough, no matter what shape you're in. A study of well-conditioned runners found performance was cut in half by early third trimester. The normal changes of pregnancy make it harder to exercise and impossible to reach your peak. Most women need 20 percent more oxygen in pregnancy. You have more blood, and your heart works harder to handle the load (increased heart rate). As the uterus grows, your spine alignment shifts forward, throwing off balance. And hormones relax the ligaments, especially in your hips and pelvis, making it easier for childbirth but harder for exercising. And yes, you gain weight -- a fact that makes many activities more difficult.

Most exercise is safe in pregnancy as long as it's done with caution. I think non-impact sports are best, to avoid possible falls or injuries. Swimming, stationary bicycles and yoga are excellent choices. Exercise classes geared toward pregnant women are another option and are a great way to meet other expectant moms. Sports you're accustomed to doing prior to pregnancy can usually be continued, but use common sense and avoid risky activities. And if you weren't active before pregnancy, be sure to go slowly.

Plan ahead. Wear loose, comfortable clothing. Drink plenty of water during and after exercise, and always listen to your body. Work up a good sweat but never push yourself to exhaustion. A good rule of thumb -- you should be able to carry on a conversation. Always warm up and cool down, and keep an eye out for things that could throw you off balance. And avoid outdoor sports when it's hot and humid. Occasional contractions are normal, but stop if you have regular contractions, experience any discomfort or feel lightheaded. Stop immediately and seek medical attention if you have chest pain or bleeding.

Regular exercise is great in pregnancy but talk to your doctor first. Women at risk for pre-term labor or complications of pregnancy should follow exercise routines tailored to their needs. Be sure to ask about specific sports that you like to do. And see if you have any medical problems that would limit your workouts.

Staying fit while pregnant is a wonderful idea -- just keep it fun and safe! --

Wishing you health,

Can hypnosis help with labor pains?

2009-11-03T14:49:00.000-08:00

I just heard about hypnobirthing. Do you think hypnosis can really help with labor pains?

You're not alone. Most women dread labor. Some say it's because we've been bombarded with negative images of childbirth. Whether it's stories from well-meaning family and friends, or comic portrayals in TV or movies, the message comes through loud and clear -- labor hurts.

Proponents of hypnobirthing say reprogramming that message in the subconscious mind is the first step toward having a comfortable labor and birth. Negative images are replaced by positive ones focused on success: "Labor brings you closer to your baby. It's the first project you will do with your baby. It's the most natural thing in the world -- why should it hurt?"

Hypnobirthing, as a form of natural childbirth, adheres to the premise that labor is easier for women who are self-assured, relaxed and cooperative. The theory of natural childbirth is that fear and anxiety lead to tension, which in turn causes pain. That pain can slow the progress of labor, which may even intensify the pain of labor and delivery. Hypnobirthing aims to make labor easier by eliminating fear and tension. It's part self-hypnosis, part relaxation (guided imagery and deep breathing) and plenty of information -- all to help break the fear-tension-pain cycle.

The specifics of labor and delivery are reviewed so you know what to expect and just in case complications arise. Women are taught how the muscles of the uterus and pelvis work so they can visualize what's happening. But again, things are presented in a positive light. Uterine contractions are called "uterine waves" or surges -- preferring to focus on the energy and strength they create.

Expectant mothers are taught to equate uterine surges with normal muscular contractions. They learn to use discomfort as a signal or cue to go into a mild hypnotic state for the duration of the surge if they choose. With self-hypnosis, the mind instructs the body to relax and open -- that it's natural to open the door, the cervix, so the baby can come out.

Women practice with audio tapes containing positive affirmations that are meant to help them reach a deeply relaxed state. For example: "I am at peace with my body. I am at peace with my baby. My body is working to bring me closer to my baby." These affirmations are then repeated by the partner or coach during labor to help trigger deep relaxation.

But it's not for everyone -- not all women are open to the mind-body connection. And to work well, it takes plenty of preparation on the part of the woman and her partner or coach. Hypnobirthing is usually taught as a series of five two-hour sessions with a certified hypnotherapist. It costs about $400 for the series so it's a little more expensive than other childbirth preparation classes.

Hypnobirthing doesn't necessarily mean your labor will be pain-free. Many women still need medication or an epidural for pain. Even so, the information and tools can help ease the process. And there's another plus -- the relaxation techniques will certainly come in handy as you try to manage the stresses of life as a new mom.
Wishing you health,

Is it safe to have an MRI or x-ray done during pregnancy?

2009-11-03T14:47:00.000-08:00

I have a question regarding the safety of MRI/MRA in the first trimester of pregnancy. I underwent an MRI/MRA of the brain when I was five-and-a-half weeks pregnant. I'm very concerned about potential problems as a result of this procedure.

I am wondering whether a therapeutic abortion is appropriate or an over-reaction? Any information you can provide regarding documented and theoretical risks to the embryo would be greatly appreciated.

That's a difficult question. Magnetic resonance imaging, or MRI, is a relatively new procedure -- it hasn't been used on large numbers of patients, so we don't have all the answers. It's always best to avoid unnecessary risks during pregnancy. Medical tests and procedures that aren't essential are generally delayed until after delivery. But complications occur and accidents happen. In these cases diagnostic procedures may be needed to find out what's going on, and how it could affect the health of mother and baby. Sometimes this occurs even before a woman knows she's pregnant. It's only natural to be concerned about the potential hazards in pregnancy.

A number of imaging techniques are used to take a closer look inside the body during pregnancy, including X-rays, ultrasound, magnetic resonance imaging (MRI) and nuclear medicine studies. Most concerns center around X-rays -- radiation is considered harmful and could lead to birth defects. But the risk from radiation depends on the amount of exposure. Fortunately, most diagnostic X-rays carry little, if any, known risks to the fetus because the exposure is very small (less than 5 rad). According to the American College of Radiology, having a diagnostic X-ray does not increase the risk of birth defects or miscarriage, or stunt the growth of the developing baby.

Ultrasound is widely used today and is one of the most common imaging studies performed in pregnancy. Ultrasound doesn't use radiation. Instead sound waves are used to create images. There have been no reports of harm to mother or baby from ultrasound and it can be safely used at any time in pregnancy.

In certain circumstances nuclear medicine studies are used in pregnancy, such as when a blood clot in the lung is suspected. The amount of exposure and risk to the baby depend on the type of isotope used for the study. By selecting the right isotope, exposure can be kept very-low and well below the threshold for risk.

MRI uses magnets and radio waves instead of radiation. Magnetic resonance angiography is a special type of MRI study that focuses on blood vessels. In some cases, contrast material is used to enhance the pictures of the blood vessels. While MRI is thought to be safe in pregnancy, our experience is limited. Until we know more, MRI is best reserved for very specific situations and is generally not recommended in the first trimester. Not because of any known problems, but due to a lack of scientific proof that it's safe. On the other hand most experts prefer to use MRI at any point in pregnancy when the alternative involves radiation.

Talk to your obstetrician about your concerns. While it's impossible to say there is no risk to your baby, the risk may be exceptionally small. Keep in mind that even in the best of situations there are risks, simply because some things are out of our control.

Making healthy choices before and during pregnancy, and getting early prenatal care, can help minimize the risk, but there are still no guarantees of a perfect baby. Learning to live with the unknown, is part of becoming a parent.
Wishing you health,

Is it possible to become pregnant while on hormone replacement therapy?

2009-11-02T14:45:00.000-08:00

Please tell me if it is possible to become pregnant while on hormone replacement therapy if your partner is younger and very virile? I'm hoping your answer is no.

A woman's ability to conceive a child diminishes as she gets older. This is especially true for women who are in the perimenopausal period of their life. Many women conceive in their fifties, and the oldest confirmed spontaneous pregnancy occurred at age 57! A good rule of thumb is to continue using birth control for one year after your last period.

The amount of hormones contained in the standard regimens of hormone replacement therapy (HRT) is about one-quarter the amount contained in low-dose birth control pills. Consequently, HRT will not necessarily prevent ovulation. This is of particular concern for women who are started on a very low dose of HRT as they transition into menopause. They need to continue to use birth control if they are sexually active.

If you started taking HRT after menopause (with ovarian failure confirmed by a lack of menstruation for one year or repeated blood tests documenting follicle-stimulating hormone and luteinizing hormone levels in the menopausal range) then you do not need to use birth control -- no matter how young and virile your partner is!

Another issue here, however, is safe sex. You must keep in mind the possibility of sexually transmitted diseases (STDs). Unprotected intercourse exposes you to gonorrhea, chlamydia, herpes virus, human papilloma virus, and HIV, among others. This is of particular concern as we age because our vaginal tissues may become thinner, making it easier to acquire an STD. Latex condoms used with a spermicide are effective in reducing the risk of transmission of STDs. It is currently recommended that in a new, mutually monogamous relationship, you should both be tested for HIV and have this test repeated in six months. If these tests remain negative, it is safe to discontinue the usage of condoms and spermicide. Be sure to check with your doctor if there are any special circumstances that apply to you.
Stay well.

What does it mean to have bacteria in your urine when you're pregnant?

2009-11-02T14:43:00.000-08:00

What does it mean to have bacteria in your urine when you're pregnant? Is it safe to take Amoxicillin for it? And what if it does not clear up? What does that mean?

A bladder infection or urinary tract infection (UTI) occurs when bacteria travel up the urethra into the bladder and multiply. If the level of bacteria is great enough, your natural immune system can't fight off the infection. Bladder infections are common in pregnancy and often lead to frequent urination, burning with urination, and urinating small amounts at a time. Sometimes, blood may even be seen in the urine. But it's normal in pregancy to have to empty your bladder all the time and only go a small amount when you do (especially in the beginning and end of pregnancy!). So these symptoms don't necessarily mean you have an infection. This opposite is also true -- you can have an infection without any symptoms at all. That is one of the reasons your urine is checked at each visit throughout your pregnancy. Women who've had frequent UTIs prior to pregnancy usually have urine cultures each trimester to look for silent or asymptomatic infections.

Amoxicillin is a penicillin derivative antibiotic and is safe to take during pregnancy. This treatment cures the vast majority of bladder infections. Women who've been treated for many prior infections often develop bacteria that are resistant to first-line antibiotics. These women may need to be treated with broader-spectrum or stronger antibiotics. And women who develop recurrent UTIs in pregnancy are often started on a low dose of antibiotic to be taken daily for the remainder of her pregnancy as a means of preventing infection.

The risk of an uncomplicated UTI during pregnancy is minimal, however some UTIs progress to a kidney infection (pyelonephritis). This condition is associated with fever, chills, nausea, vomiting, and back pain. It warrants strong antibiotics and close observation as it may lead to premature labor.

Stay well and enjoy your pregnancy!

Do you have any tips for preparing for pregnancy?

2009-11-02T14:42:00.000-08:00

I'm planning to get pregnant next year. Do you have any tips for getting prepared?

I commend you for having such a mature approach to your future pregnancy. Planning for pregnancy is not always an option, but it certainly is ideal. This enables you to make proactive choices for a healthy lifestyle that will affect both you and your baby!

A healthy lifestyle starts with a balanced low-fat diet that is high in fiber, especially in the form of fresh fruits and vegetables. Follow a program of regular exercise, at least 30 minutes a day, three times a week. Try to get your weight to within 15 pounds of your ideal. Remember, pregnancy is not a time to be dieting! Take a daily vitamin supplement that contains folic acid to reduce the chance of certain birth defects.

The early weeks of pregnancy are very important to a developing baby. This is a time when many women do not even know that they are pregnant, and unhealthy habits may be harmful to a developing baby. The safest plan of all is to not smoke, drink alcohol, or use recreational drugs even before you become pregnant.

Now is a good time to schedule a prepregnancy visit with your doctor. Be certain that any medical conditions you have, such as high blood pressure or diabetes, are under control. Are you taking any medications that need to be changed or adjusted during pregnancy? Are there any genetic disorders or health concerns in your family? Should you be tested for any sexually transmitted diseases? These are all issues that should be shared with your doctor. Your doctor can also give advice about contraception prior to pregnancy, such as when to stop taking birth-control pills.

Plan ahead and make healthy decisions. The choices you make now will help insure a healthy pregnancy next year!

What is a molar pregnancy?

2009-11-01T14:41:00.000-08:00

Could you please explain what a molar pregnancy is?

A molar pregnancy, or hydatidiform mole, is a pregnancy gone awry, resulting in a tumor of the placenta. The chorionic villi of the placenta grow into a grape-like bunch of cysts within the uterus. Molar pregnancies occur in one in 1200 pregnancies in the U.S. and 80 percent are benign. Molar pregnancies are more common in Asian women and women who are over age 40.

Most molar pregnancies are unable to support a fetus and are usually diagnosed in the first trimester. Most women with a molar pregnancy have vaginal bleeding, excessive nausea and vomiting, and some will even pass a grape-like cyst. Molar pregnancies generally grow much faster than a normal pregnancy, yet a fetal heartbeat is not heard. The swollen villi of the placenta produce a markedly elevated level of the pregnancy hormone, beta-human chorionic gonadotropin (B-hCG). An ultrasound examination can confirm the diagnosis. A molar pregnancy may also be diagnosed following a dilation and curettage (D&C) for a miscarriage or missed abortion.

When the diagnosis of molar pregnancy is made, the abnormal pregnancy tissue is removed by a D&C, and serial blood tests are performed to document falling hormone levels. The B-hCG hormone level is monitored every one to two weeks until a normal level is reached. The hormone level is then checked every few months for up to a year, to be certain that the disease is in remission and that no malignant changes have occurred.

Once remission has been confirmed, it's safe to attempt another pregnancy. Early ultrasound should be performed with any subsequent pregnancies, however, because women with a history of molar pregnancy have an increased risk of a second molar pregnancy.

I hope this information is helpful.

Stay well!

Why does my pregnant wife want to chew ice all the time?

2009-11-01T14:39:00.000-08:00

My wife is pregnant, about two months, and she wants to chew on crushed ice all the time. Is she OK? Is this normal? Should we call her doctor?

Pregnant women often have food cravings that have been known to strike at any hour of the day or night. Whether the cravings represent a nutritional need or an emotional need is debatable.

Some women, however, crave foods that have no significant nutritional value, such as crushed ice, lettuce, or even dirt. These women have a condition known as pica. In some cultures pica is very common.

While eating ice or lettuce is not harmful, eating dirt can be a source of a variety of infections and should be avoided. Additionally, there is an association between pica and iron-deficiency anemia. So, yes, your wife should discuss this with her doctor. A simple blood test is used to check for anemia.

Stay healthy!

When should I start taking my son to the dentist?

2009-11-01T14:37:00.000-08:00

When should I start taking my son to the dentist? He's 15 months old now, and I really hope to avoid all the cavities that I had growing up.

Cavities are common and treatable, but, more importantly, they're preventable. It's never too early to start thinking about prevention and a trip to the dentist is a great way to start a program of dental health. Learning the benefits of taking care of your teeth helps motivate many parents to practice good habits. And children learn from example. When they see their parents brushing and flossing, they'll want to imitate them. Taking children to the dentist at a young age can also help avoid fear down the road.

A child's first trip to the dentist should be around his or her first birthday, or six months after the first tooth appears. However, taking care of the mouth should begin at birth. The gums can be gently cleaned with a moist soft cloth, and kids need their own toothbrushes as soon as they have teeth. The teeth should be brushed at least twice a day, after breakfast and before bed. This is best done by the parents until the child is old enough to properly brush their teeth, usually around age 8.

Many people wonder why it's important to take care of baby teeth, since they're temporary and replaced by permanent teeth. Baby teeth help a child eat and speak properly. They maintain the space for the permanent teeth, and they also help a child have a good self-image. Losing a baby tooth early can lead to serious problems in the permanent teeth.

It's also a good idea to avoid caramels, licorice, raisins, and gummy bears. These taste great but they're sticky and the concentrated sugar stays on the teeth much longer than other types of sugar. And sugar and teeth don't mix -- it increases the risk of cavities.

Ask your pediatrician for a referral to a pediatric dentist or a general dentist who treats children. Choose someone that you and your child feel comfortable with.

Will I be able to breastfeed after having a lumpectomy?

2009-10-31T14:36:00.000-07:00

It's been one year since I underwent lumpectomy and radiation for breast cancer. I'm now pregnant (my first) and would like to breastfeed. What do you think?

Congratulations! I would first like to reassure you that you are not alone. In fact, one fourth of women who are diagnosed with breast cancer are premenopausal and up to a third of these women become pregnant after treatment. More and more women are delaying pregnancy until later in life, an age when breast cancer is more common. And with improved surveillance we are detecting breast cancer at an earlier stage, when it can be treated with less radical surgery.

Two main factors will affect your ability to nurse. To begin with, the location of the lumpectomy is important. A lumpectomy performed in the periphery, or outer region, of the breast is less likely to disrupt the ductal system which carries the milk to the nipple. The second factor is the extent of radiation therapy -- this tends to have a greater impact on breastfeeding. Radiation generally involves the entire breast and often produces scarring in the lobules of the breast, where milk production occurs.

It's best to have a wait-and-see approach. Initially your breasts may become very engorged when the milk first comes in. This can be painful, especially in the region of your breast surgery. The volume of milk produced by your involved breast may be significantly less than that produced by the normal breast. Some women find that the normal breast is able to compensate for the demands of the baby, while others need to supplement with formula.

Women who need further radiation or chemotherapy after pregnancy should not breastfeed. There also is no evidence that you can give your baby cancer by breastfeeding, even on the involved side.

There are many rewards of breastfeeding for both mother and baby. The only drawback that I can see in your case is that it is more difficult to detect breast lumps while you are nursing. The breast tissue remains full and somewhat engorged as long as you continue breast feeding, and for up to three months after weaning. For this reason, it's a good idea to have a breast exam with your physician every few months while breastfeeding.

Good luck and stay healthy!

Could tenderness in my breasts mean I'm pregnant?

2009-10-31T14:33:00.000-07:00

I am a 38-year-old female. I have had breast tenderness for two weeks. My breasts feel swollen and I have a tingling sensation when I wear a bra. If I take my bra off the tingling sensation subsides. My last period started 26 days ago and it was normal, but I had sexual intercourse seven days after it started. If I am pregnant this is great news for me and my husband, but I'm concerned that this could be something involving my breasts.

Yes, you might be pregnant. Breast tenderness, tingling, or swelling is often the first sign of pregnancy. And many women notice this shortly after conception, long before they miss a period.

Sperm can survive for up to five days after intercourse. Healthy sperm will swim up the vaginal canal, through the cervix, into the uterus to the Fallopian tube and wait for an egg. After ovulation, an egg can survive for only about 24 hours.

This means that if you had unprotected sex on the seventh day of your cycle (day one being the first day of your period), the sperm would be capable of fertilizing an egg anytime through day 12 of your cycle. As long as you ovulated by day 12, you might be pregnant. When trying to conceive, the best time for intercourse (the most fertile period) is just before ovulation and up to one day afterward.

What could this be if you're not pregnant? There are several possibilities. To begin with, breast symptoms can be related to starting certain medications, such as birth control pills or hormones. And some women notice this when they start new vitamins or nutritional supplements. Breast tenderness and enlargement also occur with rapid weight gain. Additionally, women with fibrocystic breasts may notice more tenderness than usual after a marked increase in caffeine intake.

Home pregnancy tests are very reliable and can help answer your question. These tests are accurate as early as seven to ten days after intercourse. If you're pregnant, congratulations! If your pregnancy test is negative, and your symptoms persist after your period, I suggest you discuss this with your physician and have a thorough breast exam.

Good luck and stay well!

What's the earliest you can take a home pregnancy test?

2009-10-31T14:31:00.000-07:00

When is the earliest you can take a pregnancy test and get a true answer? Do you have to wait until the first missed day or can you take it any sooner? Even if it is by two to three days before?

Home pregnancy tests measure human chorionic gonadotropin (hCG). This hormone is secreted by the trophoblastic cells of the placenta into the mother's blood and is then excreted into the urine. HCG levels increase over time and can be detected 8-10 days after ovulation. So, yes, pregnancy can be detected several days before you miss your period and long before many other signs of pregnancy occur.

Home pregnancy tests are very reliable when the directions are followed exactly. Sometimes a test is done a little too early and a negative result is obtained, even though the woman is pregnant. For this reason, it's a good idea to repeat the test if your period has not started within a week. Good luck with your test: I hope it gives you the answer you are looking for.

Stay healthy!

Is there a proper way to breast feed?

2009-10-30T14:28:00.000-07:00

I am writing for a friend who is pregnant and due any day. She is interested in breastfeeding and wants to know if there is an organization she can call to teach her the proper way to breastfeed.

Breastfeeding offers tremendous benefits to mother and baby. Being skin to skin promotes bonding while providing proper nutrition as well as advantages for the immune system. It's convenient, inexpensive and an excellent way to help get back to pre-pregnancy weight!

As for learning the proper way to breastfeed, there is no one perfect way. The best way is usually the way that works best for mom and baby, and this often involves a period of trial and error. While it's the most natural thing in the world for many moms and babies, other pairs need more on-the-job training. It's important to stick with it during the first few weeks, which are always tough. It takes about a month to establish a feeding rhythm and that's when it gets easy.

Have your friend contact La Leche League International, Inc. (9616 Minneapolis Ave., Franklin Park, IL 60131). They offer support and guidance for breastfeeding women. Many childbirth education programs offer classes in breastfeeding. And most new moms receive helpful advice and instruction from the nurses at the maternity ward at the hospital.

Breastfeeding should be encouraged, but it is a matter of personal choice and it's not the right choice for every woman. Some women have medical conditions that prevent nursing, or are taking medications that would be harmful if passed through the breast milk to the baby. Other women try nursing and find that it's just not right for them. Whatever you decide, remember it's your body, and do what's right for you!

Does alcohol aid with breast feeding?

2009-10-30T14:27:00.000-07:00

Does spacing affect preterm birth or low birth weight?

2009-10-30T14:25:00.000-07:00

I just had a baby in January and I'm already starting to think about the next one! Can you tell me what's the best spacing between kids?

You've asked a very interesting question, but there's no simple answer. For years people have debated the merits of having children two, three, or even four years apart, and valid arguments can be made for each.

Well, now researchers from the Centers for Disease Control and Prevention (CDC) are tying to answer the question on spacing. An interesting study published in the New England Journal of Medicine (NEJM 1999;340:589-594) looked at how spacing affects pregnancy. Bao-Ping Zhu, MD, and colleagues studied the birth certificates of over 173,000 babies born in Utah from 1989-1996, to see if the interval between pregnancies affected birth weight or preterm birth.

They found that babies who were conceived 18-23 months after a previous birth had the lowest risk of preterm birth or low birth weight. And they found that the risks were increased when fewer than six months or more than ten years had elapsed between the birth of one child and conception of the next.

While these findings are helpful, this remains a very personal issue. For many it's a matter of personal preference. However, for others spacing may not be their choice, but may be dictated by financial or job-related concerns, or even infertility.

Whatever the spacing, children are affected by the birth of a sibling. On a bright note, they become more independent. However, many children regress, strive for attention, and may even become hostile or aggressive with the new baby.

Whatever you decide, be sure to give yourselves some time to conceive. It's usually better to be pleasantly surprised than disappointed. And remember, practice makes perfect!

Stay well!

What's the best way to test for abnormal chromosomes during pregnancy?

2009-10-29T14:23:00.000-07:00

Hi! I am 35 and nine weeks pregnant with my third child. My husband and I are weighing the merits of amniocentesis vs. chorionic villus sampling. We would like to know the relative rates of miscarriage of the two procedures. I have also heard that there is a possibility of limb malformation with CVS. Is this true? We also may skip both tests and rely on an AFP test and sonogram. Thanks for any info.

Deciding how to proceed can be difficult. I'm glad to hear that you're weighing your options. A woman's risk of delivering a baby with a significant chromosomal abnormality increases with age. At age 30 the risk is 0.26 percent, it increases to 0.56 percent at 35, and the risk is over 5 percent at age 45. Amniocentesis and chorionic villus sampling (CVS) are the two main ways to test for abnormal chromosomes during pregnancy. If a problem is found, parents can decide whether to terminate the pregnancy, or continue the pregnancy and be prepared for delivering a child with special needs.

Amniocentesis is is the gold standard and is the safer of the two procedures. Amniocentesis has an overall complication rate of 0.5 percent, including needle stick injuries to the fetus, infection, or leaking membranes. Nationwide, the risk of miscarriage from amniocentesis is only slightly higher than the risk of miscarriage in women who have not had an amniocentesis (3.5 percent vs 3.2 percent). In addition to checking the chromosomes, amniocentesis also checks the alpha-fetoprotein level which screens for major malformations such as neural tube defects.

The main drawback of amniocentesis is the timing of the test. This procedure is done in the second trimester at about 16 weeks and it takes a week to ten days to get the results. It can be hard waiting until 18 weeks to find out if all is well. Many centers now offer early amniocentesis which is performed closer to 12 weeks of pregnancy. The complication rate is a little higher than for traditional amniocentesis, but the results are available sooner.

The advantage of CVS is that it's performed earlier in pregnancy -- between ten and 12 weeks -- and the results are available sooner. When CVS was first introduced there were case reports of limb reduction malformations that may have been linked to very early procedures, around eight weeks. Nationwide, the risk of losing a baby after CVS is at least twice the risk of amniocentesis (range 1-4 percent). Additionally, about 10 percent of women have bleeding, spotting or cramping after CVS. Another drawback of CVS is that it does not test directly for AFP levels, so women who undergo CVS need to have a blood test for AFP in the second trimester.

While CVS has greater risks, taking those risks is appropriate for some women, especially those over 40 and also women who are very anxious. Since you have two healthy children and are only 35, amniocentesis may be a better choice. And if you prefer a risk-free approach, a detailed ultrasound and a triple test or AFP would be the next step. Only you and your husband know what's best for the two of you and for your family

Why do I have discharge oozing from my breast?

2009-10-29T14:19:00.000-07:00

Lately, I have been having a little bit of discharge from my right breast. It ranges from clear to milky white liquid. I am worried because I don't know if something is seriously wrong, or if it's normal. I have been told that milk is only produced when you're pregnant. Could this be a symptom of me being pregnant?

It's natural to feel anxious when you notice something new in your breast. Some women notice a spontaneous nipple discharge that stains the inside of a bra or leaves a crusting on the tip of the nipples. For others, the discharge occurs only when the nipple area is squeezed, and yes, a milky discharge can be seen in pregnancy. While it's normal to be able to express a few drops of milk for up to a year after giving birth or weaning a child, a nipple discharge in a woman who is not nursing needs to be evaluated. Most discharges are linked to benign changes in the breast, but it can also be a sign of breast cancer.

Galactorrhea refers to the milky nipple discharge that is not related to pregnancy or breastfeeding. It can involve both breasts or just one, it's usually white or clear, but may be yellow or even green. Galactorrhea can result from increased prolactin hormone secretion by the pituitary gland, or it may be associated with a sluggish thyroid gland (hypothyroidism). Many drugs are known to cause galactorrhea; these include estrogen (birth control pills), phenothiazines, reserpine, butyrophenones, tricyclic antidepressants, metoclopramide, verapamil, and cimetidine. The discharge associated with these medications usually comes from multiple duct openings in both breasts. Trauma to the breast, surgical procedures, anesthesia, and stress have all been linked to galactorrhea. And some women have found that suckling of the breast, such as during sex, can trigger a nipple discharge.

Fibrocystic changes in the breast are a common cause of nipple discharge among premenopausal women. The discharge is usually spontaneous from multiple ducts in one or both breasts, and is most pronounced just before menstruation. The discharge may be green or even brownish and sometimes a biopsy is necessary to fully evaluate the problem.

Discharge that comes from a single duct and is clear or blood-tinged is usually caused by a benign intraductal papilloma or duct ectasia, but is occasionally due to an intraductal cancer, which is more common after age 50. A thorough breast exam and mammogram are indicated, and a ductogram may also be necessary. Treatment of the benign conditions usually involves removal of the duct.

Evaluation of nipple discharge includes a thorough breast exam to screen for lumps and also to check which ducts are involved. Blood tests for thyroid function (TSH) and prolactin are indicated for women with galactorrhea. A mammogram is also appropriate if there is a mass, or based on age alone. And the discharge itself may be checked for signs of infection, blood, fat droplets (seen in milk), or cancer cells.

There are a number of reasons why you may have a discharge from your breasts. While nipple discharge is usually due to a benign process, it's always best to see your doctor for a thorough evaluation

Since I've stopped breast feeding, I've started losing my hair, why?

2009-10-29T14:18:00.000-07:00

I had my second child almost six months ago and stopped breastfeeding when she was five months of age. I have been experiencing extensive hair loss since I stopped breast feeding. This also occurred after I stopped breast feeding my first child, but I didn't lose as much hair, or for as long. Is there any thing I can be doing to stop this? Is it hormones? Should I be concerned and make an appointment to see a doctor? And, if so, which type of doctor? OB/GYN? Thanks for any info!

Women often notice thicker hair during pregnancy. That's because routine hair loss is temporarily suspended. Normally our hair follicles are out of synch -- we lose some hairs (about 100 hairs a day!) and grow others simultaneously. But the high levels of estrogen and progesterone in pregnancy can increase the synchrony of hair growth, which in turn can lead to periods of growth or shedding. When hormone levels return to normal, usually three to six months after delivery, there is often a sudden loss of hair as a large number of growing hairs enter the dying phase.

Fortunately, this diffuse shedding of normal hairs resolves over time without any specific treatment. However, if you're losing clumps of hair, or notice patches or bald spots, ask your doctor for a referral to a general internist or a dermatologist. Hair loss can occur in a variety of situations. With a thorough evaluation, the cause can usually be determined and appropriate treatment started.

Your belly button in pregnancy

2009-10-28T14:16:00.000-07:00

Will my "out-y" belly button become an "in-y" belly button, once again after pregnancy? Does this mean my muscles have separated?

Pregnant women often notice that as their abdomen pops out, so does their belly button. It's linked to your growing baby. In her book, "The Girlfriends' Guide to Pregnancy," Vicki Iovine says it very well: "Think of yourself as a Butterball turkey -- when your belly button pops out, you're about done."

Many women start to feel like "it's someone else's body" during pregnancy, and the "out-y" belly button is a good example. Some display it proudly, yet others try to hide it with a band-aid or flatten it with a nickel and a piece of tape. Late in pregnancy, your belly button may lead the way into a room, but it generally returns to normal soon after birth.

Separation of the muscles is another matter. The abdominal muscles are a pair of muscles joined by a seam in the middle. Hormones released during pregnancy allow this seam to soften and stretch as the abdominal muscles accommodate the growing baby. If this seam stretches a lot, separation of the muscles can occur. The separation isn't painful, but because these muscles help maintain good posture, it often leads to backaches. If you have a separation, mild strengthening exercises in a diagonal direction, such as reaching your right arm across to your left knee, can help bring the muscles together. Be sure to tighten your abdominal muscles whenever lifting, and avoid straining of any kind.

Although the pressure inside the abdomen is increased during pregnancy, and hernias can develop at weak spots near the navel (umbilical hernia), serious hernias are rare. Women often find that their protruding belly button is sensitive; but any severe or constant pain should be evaluated to make sure there is no hernia.

Is it safe to diet while nursing?

2009-10-28T14:14:00.001-07:00

Is it safe to diet when I'm nursing? I just had my first baby and can't seem to lose the 35 pounds I gained.

A healthy weight gain in pregnancy is between 25 and 35 pounds, but losing that extra weight can be tough. While some women are back in their normal clothes in just a few months, it usually takes a year to lose all the weight. Breastfeeding can help -- nursing burns an extra 300-500 calories a day. But what if you want to lose the weight more quickly -- is it safe?

Well, according to a recent study in The New England Journal of Medicine (NEJM 2000;342:449-453), the answer is yes, breastfeeding moms can safely lose a pound a week without hurting the growth of their babies. Starting one month after childbirth, 40 breastfeeding moms and babies were randomly assigned to a program of diet and exercise or to a control group. Women in the study group cut 500 calories a day and exercised 4 days a week. The results were encouraging. After ten weeks, the diet and exercise group had lost an average of 10 pounds, compared to a 1 pound weight loss in the control group. But, while they were losing weight, their babies continued growing right along. Babies in the two groups had similar amounts of growth, both in terms of their weights and their lengths.

This is great news for nursing moms. Losing those extra pounds with the tried and true method of moderate exercise and calorie restriction is safe and should not affect your baby. But be sensible. The secret is moderation. No crash diets! Losing a pound a week is a safe, healthy goal. You're more likely to stick with it and keep the weight off in the long run when it's done gradually.

Can fibroids complicate a pregnancy?

2009-10-28T14:14:00.000-07:00

I am 33 years old, and entering the 33rd week of my first pregnancy. Three weeks ago I found out I had a myoma on my uterus. At the time it was even causing pain and contractions, so I have had to stay in bed ever since and take medicine. Fortunately the contractions have subsided, and it seems that my pregnancy will continue without further problems.

However, I am afraid that the myoma is growing bigger and bigger, you can see it and feel it just next to my navel without any instrument's -- help!

I would like to have more children in a few years, I suppose that, before the second pregnancy, the fibroid will have to be taken out. Do you think that, given the circumstances, it would be possible or recommendable to undergo a Cesarean section, and have my baby and get rid of the tumor in one go? I look forward to hearing from you.

I'm glad your contractions have settled down. I know how hard it can be dealing with the threat of preterm labor, and how frustrating it is to be on bed rest. You've raised an excellent question -- what to do about a fibroid that's causing trouble in pregnancy. Uterine fibroids, or leiomyomas, are very common and usually not a problem during pregnancy. But for some, fibroids can wreck havoc in an otherwise uncomplicated pregnancy.

These smooth muscle tumors can grow during pregnancy in response to elevated hormone levels. When there's rapid growth, it can lead to pain or pressure, or even trigger preterm labor. Large fibroids can also affect the position of the baby, or prevent normal labor and delivery by blocking the path of the baby through the birth canal.

As your pregnancy continues your doctor will monitor the position of the baby, checking to see if she is head first and how well she's moving into the pelvis. Since your fibroid is up near your belly button, it's possible that it won't affect labor or delivery at all. After delivery, hormone levels fall and fibroids shrink dramatically -- sometimes they don't even grow with future pregnancies.

If your baby is breech, then a C-section may be recommended. In that case, your doctor might feel that removing the fibroid at the same time is wise. But again, this depends on the size and location of the fibroid, which may not be clear until the time of surgery. There's no sense in taking unnecessary risks where your future fertility is concerned.

When it comes to fibroids in pregnancy, a "wait and see" approach is usually best. I hope you enjoy the rest of your pregnancy.

Are breast exams necessary while nursing?

2009-10-27T14:09:00.000-07:00

I try to do breast self-exams, but I am breastfeeding. What are your recommendations about self-exams and mammograms while nursing?
I also remember hearing that breastfeeding decreases the chances of getting all kinds of cancer, including breast cancer. Is this true?

Monthly breast self-exams are just as important when you're pregnant or nursing as at any other time in your life. Perhaps even more so, because women who get breast cancer during pregnancy or while nursing may have a worse prognosis as the diagnosis is often made at a later stage. Physiologic changes that occur with pregnancy and lactation can make it harder to detect and evaluate breast lumps and pregnant women or new moms live's are focused on things other than breast cancer.

Breast self-exams help you get to know what's normal. Granted, when you're pregnant or nursing your breasts will feel quite different from before pregnancy. Early in pregnancy, breasts often feel the way they do right before you get your period, tender and full. As pregnancy continues the fullness remains, yet the tenderness usually subsides. During breastfeeding, the glands swell with milk making the breasts full and lumpy.

It's best to do a breast self-exam after a feeding so the breasts are relatively empty. Any prominent lump that doesn't go away with massage needs to be checked out. Ultrasound, aspiration, core needle biopsy and surgical biopsy are all safe in pregnancy or while nursing. Mammography during pregnancy or lactation can be painful and usually isn't very helpful because the breast tissues are more prominent making it harder to interpret the pictures. Routine mammograms, for women with no symptoms, are generally scheduled three to six months after the end of nursing to allow breast tissues time to recover.

Breastfeeding offers many healthy benefits to mother and baby alike. It can prevent ovulation and will decrease the risk of ovarian cancer.

The results from studies looking at the effect of breastfeeding on breast cancer risk have been mixed -- some say it helps, others don't show a difference. A recent study from Yale University found that Chinese women who breastfed their babies for at least two years cut their risk of breast cancer by up to 50 percent. The researchers say they don't know why it lowers risk but speculate that prolonged nursing reduces overall exposure to estrogen. These findings are encouraging, yet hard to apply to American women who typically breastfeed for a much shorter length of time.

So, get to know your breasts and check them regularly. But above all, enjoy the time with your baby.

Stay well!

BABY ON BOARD: Transporting your infant safely

2009-10-27T11:53:00.000-07:00

Under most circumstances, where could a baby be more secure than in a parent's arms? But in a moving vehicle, that becomes a dangerous place. In the event of a crash, your body could crush your baby against the dashboard or windshield. Even if you wear a seatbelt, your baby could be torn from your arms by the force of a collision.

Because of this danger, child car seats are required by law in every state. In a collision, these rigid seats — when used correctly — support babies' backs, necks and heads. Unfortunately, many parents unintentionally misuse their infant car seat, dramatically reducing its effectiveness in a collision. By giving careful thought selecting a seat and paying close attention each time you use it, you can help ensure a safe ride for your baby.

Please, have a seat

There are two types of car seats for babies. You'll need to decide whether to select a seat designed specifically for infants (it will have to be replaced when your baby is older), or a convertible seat that accommodates either infants or toddlers. Infant-only car seats accommodate babies from birth to approximately 20 pounds. They are installed rear-facing so that the baby always faces the back of the vehicle — the only safe position for infants in cars. These small, portable seats hold the baby in a gently reclining position. Many models come with a detachable base that remains installed, letting you snap the seat in and out of your vehicle.

Infant-only car seat

"Infant-only seats provide a better fit for a newborn than convertible seats," says Dawn E. Nelson, R.N., pediatric critical care outreach coordinator at Mayo Eugenio Litta Children's Hospital. In a seat that's too big, a young infant may not be properly positioned. This increases the risk of having the head fall forward, possibly interfering with breathing. "It's very important to be sure, after installing the seat, that the baby is reclining at a 45 degree angle, to provide proper positioning for the baby's airway," Nelson says.

Convertible car seat

If you do choose a convertible child seat, use a model that uses a five-point harness fastening system. "Avoid models with a t-shield or tray shield, especially for newborns," Nelson says. "On impact, the baby's body may hit the hard plastic shield, causing head, abdominal and chest injuries."

Nelson recommends trying a number of car seat models in your vehicle before selecting one. Many stores will let you test several seats in your car before making a purchase. If you decide to borrow or buy a used car seat, make very certain that the seat is safe. "Before choosing a secondhand seat, it's very important to know the history of the seat, " Nelson says.

Avoid purchasing a used seat that:

Was involved in a crash.
Has no labels.
Is older than 6 years.
Has cracks or rust.
Has any parts missing.
Has been recalled.

Keep three important factors in mind when selecting a car seat for your child. Choose a seat that:

Fits your child well.
Fits tightly into your vehicle.
Will be used correctly each time.

The following guidelines should help you choose and safely install a car seat:

Read the labels — Some of the new infant carriers can easily be confused with infant car seats, so be sure to read the label for appropriate use. Check also to be sure it carries the following message: "This child restraint system conforms to all applicable Federal Motor Vehicle Safety Standards."
Check your rear — A vehicle's back seat is the safest place for any passenger, because it's farther from the point of impact in a head-on crash — the most common type of collision. Be sure the car seat you choose fits securely in your vehicle's rear seat. The center of the rear seat is ideal. However, some vehicle seats are contoured for adult bodies, making safe installation of car seats difficult. You may need to install the seat on the passenger or driver side of your rear seat. Carefully read both your vehicle owner's manual and the car seat instruction manual for useful, specific installation tips. To properly install a child safety seat, make sure the seat is pressed against the back of the vehicle's seat. Nelson recommends that parents climb into the vehicle and kneel into the child car seat while routing the seat belt through the correct belt path on the seat. If you're uncertain which belt path to use, check the label on the child car seat. When the seat is properly installed, you shouldn't be able to move it more than one inch from side to side or front to back.

Cover your bases — Your best bet is to select an infant-only seat with a base, and take the time — generally about 10 minutes — to install the base securely in your rear seat. If you use more than one vehicle to transport your baby, Nelson recommends ordering an additional base from the manufacturer and installing it in your second car, so you can simply snap the seat out of its base when you transfer vehicles. Some vehicle designs may not permit secure installation of an infant seat with a base. To be safe, 80 percent of the infant seat must be positioned on your vehicle's seat; if a base causes more than 20 percent of the infant seat to hang over the edge of your vehicle's seat, you should use a seat without a base.
The air bag that saves your life could kill your child — Airbags work well to protect larger children and adults who ride facing forward. They aren't safe when used with rear-facing child car seats. A minor collision can cause the air bag to inflate with a force strong enough to seriously injure and even kill a child. In the past several years, nearly 20 serious injuries and deaths were reported in infants who were wrongly restrained in the front passenger seat during a minor impact that caused airbag deployment. In vehicles with passenger-side air bags, rear-facing infant seats and convertible child seats must always be placed in the back seat. Children should not ride in a front passenger seat until they are 13 years old, Nelson says.

Selecting a safe car seat is a crucial first step, but there is still much more to protecting your child:

Register with the manufacturer — Car seats are regularly tested for safety standards and may occasionally be recalled because of a problem. Once you've purchased a car seat, be sure to send in the registration card so the manufacturer can get in touch with you in the event of a problem or recall. "Many parents don't send in their registration cards because they're afraid of being placed on additional mailing lists," Nelson says. If you choose to use a secondhand seat, and you aren't sure if a registration card was sent in, you can call the National Highway Traffic Safety Administration (NHTSA) .

Before you drive — Seasonal clothing and growth both may affect your baby's fit in the car seat, so it's best to make sure your baby is comfortable and snugly secured each time you drive. The car seat's harness should come up at or below your baby's shoulders. The harness straps should not be twisted, and they should be secured with a harness retainer clip placed at armpit level. If the harness is tight enough, you should not be able to fit more than one finger width between the harness and the baby. Don't wrap your baby in a blanket until after he or she has been secured in the car seat. The carrying handle on an infant-only car seat must be in the down position while in transit. "A lot of parents want to hang toys or mirrors from the handle," Nelson says. "But it's crucial to keep it down, to prevent your baby from hitting the hard plastic handle in a collision."
Create a safe space — Keep your car's passenger space free of objects that could hurt your baby. Select car toys that are soft and can't easily be thrown, and keep groceries and other loose objects in the trunk or in another safe place away from your child.
Err on the safe side — Your baby should ride in a rear-facing infant seat until he or she weighs at least 20 pounds and is at least 1 year old. Nelson says that many parents make the dangerous mistake of turning their baby to ride forward-facing too soon. Until babies reach 1 year of age, the muscles in their neck aren't very strong. In a collision, a forward-facing baby is at greater risk of head and neck injuries because its head may be thrown forward.

Nelson also urges parents to discard a car seat after an accident. "Any time your car is involved in a crash — even a minor collision — the car seat should be replaced," she says.

Transporting your tiny baby

A premature baby may have trouble breathing in the semi-reclined position of most infant car seats. Car beds are now available which have been designed and crash-tested, making it possible for a premature infant to ride safely. Ask your health care team whether your baby might need a car bed. They can also help you practice securing your baby safely before leaving the hospital.

Precious cargo

Take the time to make an educated selection when buying a car seat so that every car trip that you and your baby take — no matter how short — is as safe as it can be.

PREMATURE BABIES

2009-10-26T11:49:00.000-07:00

Most people think that a typical pregnancy lasts 9 months. That's not exactly the case. A pregnant woman's "due date" is generally considered to be 40 weeks from the first day of her last menstrual period, with conception usually occurring about 14 days later.

A baby born more than 2 weeks before its due date is considered premature. Because premature babies have not had time to fully develop and build strength in the womb, they are at increased risk for medical and developmental problems.
If a woman goes into labor before 36 weeks, her doctor will usually try to delay the birth, to give the baby more time to mature. However, this is not always possible, and some women give birth many weeks before their due date. Many advances have been made in caring for premature infants, and today even babies born at 25 weeks have a good chance of surviving.

We interviewed neonatologist Robert V. Johnson, M.D., about caring for premature babies.

We: What are the survival odds of premature babies, based on the week they are born?

Dr. Johnson: Babies born before or at 23 weeks probably have less than a 30 percent to 50 percent chance of surviving. Survival rates increase dramatically after 23 weeks. Babies born at 24 weeks have between 60 percent and 90 percent survival odds, depending upon how healthy they are at birth and how well they respond to initial medical care. Survival odds continue to increase the later a baby is born. A baby born at 25 to 26 weeks has between 80 percent and 90 percent survival odds, while a baby born between 33 and 36 weeks has a 98 percent chance of surviving. These are U.S. statistics.

We: What are the most serious medical or developmental problems for premature babies who survive their newborn hospital stay?

Dr. Johnson: The likelihood that a premature baby will develop chronic medical or developmental problems varies widely with their age at birth. I'll focus on the most important complications and the likelihood of their occurrence in babies born in the highest risk group, those born around 23 to 26 weeks.

One condition that very premature babies are at risk for is intracranial hemorrhage, or bleeding in the brain. The likelihood of the most serious intracranial hemorrhage ranges somewhere between 10 percent to 20 percent, with the higher numbers in the youngest babies. If brain bleeding occurs, it usually takes place within the first week to 10 days of life. The most severe bleeds, referred to as Grade 3 or Grade 4, carry the greatest likelihood that the child will develop serious problems, including developmental delays, seizures, learning disabilities, intellectual impairment and hydrocephalus (fluid accumulation in the brain). Mild cases of intracranial hemorrhage may require only observation, while severe cases may require operations to relieve excess fluid accumulation in the brain.

Another problem seen in the youngest and smallest premature babies is called retinopathy of prematurity, or ROP, a problem affecting the light-sensitive inner lining of the eye. This problem is seen most frequently in babies born at 24 to 26 weeks. The sicker a baby is, the greater the likelihood of serious problems with the developing retina. Many cases of ROP resolve on their own, while severe cases may be treated with cryotherapy, in which an extremely cold instrument is used to prevent retinal detachment.

There is also a risk of a potentially severe problem with the intestines referred to as necrotizing enterocolitis, or NEC. In the most serious cases, this condition can be life-threatening. At the very least, it can delay feedings and require intravenous nutrition and antibiotics for a week or two. This condition is seen in 5 percent to 7 percent of babies born before 28 to 30 weeks.

Perhaps a third of babies who survive after birth at 23 to 25 weeks may have serious, lasting neurologic problems, developmental delays, or significant cerebral palsy, hydrocephalus or seizures. About a third of these babies will have some chronic problems that are not considered major, such as mild cerebral palsy, the need to wear glasses and have ongoing eye care, or slight developmental delays.

Another third of these babies born at 23 to 25 weeks will do very well at first, showing no overt signs of any problems when they're sent home from the hospital. This group of babies is fortunate enough to have had no significant brain bleeding, no significant eye problems, and no other major difficulties that would seem to affect their long-term development. Yet, we know that as these children reach school age, most of them are not going to perform as well in school as their peers or as their siblings. The consequences of extreme prematurity still leave them with some problems.

We: Do all premature babies experience medical or developmental problems?

Dr. Johnson: It depends mostly on the gestational age of the baby and complications encountered during their newborn hospitalization. The highest risk of problems is in the youngest preemies. Even by 28 to 30 weeks, the risks of these complications is lower. The good news is that by 32 to 35 weeks the medical problems are usually short-term and resolved or nearly so by the time of hospital dismissal.

We: What specific care do most hospitals provide for premature babies? What can parents expect from the neonatal (newborn) intensive care unit (NICU)?

Dr. Johnson: The NICU is designed to provide care for premature babies and full-term babies who develop problems after birth. Doctors and nurses specially trained to care for newborns with medical problems will provide round-the-clock, intensive care for your baby. Your baby will probably be kept in an isolette, an enclosed plastic box that is kept warm so your baby will be able to maintain normal body temperature. There will probably be various tubes inserted and wires taped to your baby, which serve to deliver fluids, nutrition, and medication, and also to monitor blood pressure, heart rate, breathing and temperature. Caregivers may also use equipment, like ventilators, to help your baby breathe. All of the high-tech equipment may overwhelm you at first, but it's all designed to help your baby.

We: What can parents do to stay involved in their baby's care while he or she is in the NICU?

Dr. Johnson: While it may seem like the care of your premature baby is out of your hands, parents actually play a very significant role while their baby is in the NICU. Your baby's caregivers will help you learn how to touch and eventually hold your baby in ways that are reassuring, and not over-stimulating. Talking or singing softly to your baby at times, and just providing quiet company at other times, will provide great support and comfort. Eventually, when your baby is ready, the nurses will help you learn to feed your child.

We: What factors determine when preemies are ready to go home?

Dr. Johnson: Babies are ready to go home when they no longer have medical problems that require continuous hospital care, when their body temperature is stable without needing the isolette, and when they can nurse well enough to gain weight. There's no specific weight or age that a baby must reach before going home.

We: What should a parent expect in terms of follow-up care for their preemie? How often will they need to return for medical check-ups, etc.?

Dr. Johnson: Before you take your preemie home, your doctor will provide guidelines for caring for your baby at home. You should feel free to ask a lot of questions before going home with your baby. A follow-up visit will be scheduled for the near future, so your doctor can examine your baby, answer your questions, and talk with you about how things are going at home. Immunizations usually begin after the baby is 2 months old. Premature babies generally have more frequent trips to the doctor until we're confident that they are growing well and tolerating illnesses successfully.

Eating Smart: Nutrition Tips for Pregnancy

2009-10-26T11:46:00.000-07:00

Shannon couldn’t believe the news, her suspicions were correct, and repeating it to herself made it all the more real, “I’m pregnant, I’m pregnant”, she said all the way home from the doctor's office. But, at age 42, she was a little overweight and didn't want to panic, thinking about how much weight the upcoming nine months would add on to her small to medium size body frame. “I want my baby to get the best start in life, but I don’t want is to be straddled down with so much extra weight that it’s tough to work off,” she told her husband as they were out celebrating the good news.

One of most nutritionally demanding times in a woman’s life is during pregnancy. The requirement for some nutrients more than doubles yet the calorie intake should only increase by 15%. Like Shannon, most expectant mothers face the challenge of getting enough nutrition while not gaining too much weight.

Weight Gain During Pregnancy

Women need to add an additional 300 calories to their diet during pregnancy. On the average, the recommended weight gain is in the range of 25-35 pounds. During the first three months, most women will gain between two and four pounds. Throughout the remainder of the pregnancy the average weight gain is one pound per week.

Nutrition and Fetal Development

We all want to have a healthy baby and much of that depnds a mother’s good nutritional habits. The greatest gift you can give your developing baby is eating a well- balanced diet everyday throughout your pregnancy.

Necessary Nutrients for Pregnant Women Include:

Protein: Protein provides the growth element for body tissues. The RDA recommends 60 grams of protein a day for pregnant women, or two to three servings daily. Eggs, lean meats, beans and tofu constitute high-protein foods.

Calcium: Calcium is the building block for strong bones and teeth. During pregnancy a woman needs 1200/mg day, or four servings a day. Calcium is found primarily in milk products, broccoli and canned salmon.

Iron: Iron is necessary for strong blood. Iron requirements double during pregnancy, and equal 15-30mg per day. Foods rich in iron include liver, red meat and dried fruit. It is recommended that women take a vitamin supplement containing 30 mg of iron during the second and third trimesters.

Folic Acid: Recent studies suggest that folic acid reduces the risk of spina bifida and related birth defects by around 50%. Folic acid is found mainly in orange juice, green leafy vegetables, and beans . A supplement is usually added during pregnancy. It is recommended that all women considering getting pregnant take 400 micrograms of folic acid daily.

Are Prenatial Vitamins Essential?

Nutritious foods should be the first place you look in meeting your vitamin and mineral requirements during pregnancy. Taking a vitamin supplement is a good way to fill in the nutritional gaps when you are not getting adequate daily nutrition. However, some select women do require prenatal vitamins, these include women having multiple births, heavy smokers, alcohol and drug users.

What should I avoid?

Caffeine: The connection between caffeine and pregnancy is controversial. It is recommended pregnant women consume no more than 200 mg of caffeine per day .
Food Additives: There is no evidence that food additives such as MSG are harmful to a developing fetus.

Artificial Sweeteners: Aspartmae, commonly marketed as Nutrasweet is approved by the FDA as being safe for pregnant women.

Medicines: It is better to avoid all over the counter medicines during the first eight weeks of pregnancy. This is the when your baby’s heart, lungs and brain are being formed.

Occasional alcohol: The effects of occasional alcohol during pregnancy are unknown, so most health experts recommend against it. Some studies show that some pregnant women who consume one to two drinks daily give birth to smaller babies. Excessive alcohol use leads to serious fetal risks.

Some Serious Health Conditions Affecting Pregnancy:

High Blood Pressure during pregnancy can cause serious complications including a decrease in blood and oxygen to the baby. Women who smoke, are overweight, or have diabetes are at higher risk. If you suffer from high blood pressure, your doctor may put you on strict bed rest.

Gestational Diabetes affects between 3 to 6 percent of pregnant women. Screening for (GDM) should be done between 24-28 weeks. The treatment for this condition involves following a special diet, exercise and in some cases taking insulin injections.

Smoking During Pregnancy has serious affects on the fetus. When a mother smokes, nicotine and carbon monoxide get into the placenta, preventing the fetus from receiving the food and oxygen necessary to grow. The result is often is a baby with a low birth weight.

Heavy use of Alcohol during pregnancy can cause severe mental retardation. The condition is known as fetal alcohol syndrome. In addition, many children born to mothers who drink suffer from learning disabilities, hyperactivity and aggressive behavior.

Your Baby Depends on You!!!

The better you eat; the better you’ll feel throughout your pregnancy. The nutrition lifeline flows between you and your baby, and it’s important to ensure every child a healthy beginning. Remember, what’s good for you is also good for your baby.

Breast pump question

2009-10-26T11:43:00.000-07:00

My daughter is having a baby soon, and we want to get her the best breast pump we can get. She is worried about this being painful, and she also works a full-time job. What advice can you offer?

There have been major improvements in breast-pumping equipment in the past decade. Working mothers now have much more convenient and efficient means of providing the recommended nutrition — breastmilk — for their infants. There are even self-contained pump-and-storage devices that come in discrete briefcase-like containers.

Efficiency is very important. You can cut pumping time in half by pumping both breasts at once with a double-breast pump. Electric, automatically pulsating pumps are more efficient than the hand-operated kind. It takes about 10 to 15 minutes per session with an automatic double-breast pump. Double-pumping also is the most efficient way for mothers to maintain their milk supply.

Automatic pulsating double-breast pumps can be purchased or rented. Renting, rather than buying, is often a preferred option for the highest-quality, hospital-grade pumps. For information on rental options, check with your hospital or contact a lactation consultant. A lactation consultant also can advise you on how to use a breast pump properly and develop a good schedule of pumping and feedings.

As for the question of pain, a high-quality pump is not uncomfortable when used properly. If there is pain during use of a breast pump, call your health care provider or lactation consultant.

Which foods should be avoided during breastfeeding?

2009-10-25T11:42:00.000-07:00

A healthy, well-balanced diet with as few restrictions as possible is what mothers and their nursing babies need. With the exception of alcohol, there are no other foods that need to be avoided during breastfeeding.

Alcohol can be passed on to a baby through breast milk, in a concentration similar to that in the mother’s blood. Because the baby is at a developmental stage in which alcohol could cause problems, it’s best to abstain while breastfeeding. Alcohol may also interfere with a mother’s ability to nurse by impairing milk release.

Caffeine also passes into breast milk. Excess caffeine may make an infant irritable and wakeful. However, one or two servings of caffeinated soda, coffee or tea each day should not cause a problem.

In families with a history of allergy to cow’s milk, a mother’s consumption of cow’s milk may cause colic in a nursing baby. In such cases, the mother may wish to drink fortified soy or rice milk instead.

Occasionally, babies may seem sensitive to something in their mother’s diet. Many foods — such as onions, broccoli, garlic, beans and asparagus — may alter the taste and odor of breast milk. However, it’s unlikely that you need to eliminate these foods from your diet. Babies can act cranky or fussy at times. Sometimes you may suspect a food reaction when in fact your baby is just acting fussy that day. If you suspect a food is causing a difference in your baby’s disposition or stool patterns, discuss it with your child’s doctor.

Staying in Shape

2009-10-25T11:35:00.000-07:00

Working out is the key to keeping the weight off and feeling good. Aerobic activity and light weight lifting lifting can do the trick. Whether it's going to the gym or sweating it out at home to a video..the important thing is to keep it moving.

You are what you eat..It's hard to eat healthy with kids around. Don't give up the fight . Learn how to eat low fat and try some cool substitutes for some old favorites.

Why It's Important

Having children later in life has its advantages. Most midlife moms are accomplished in their careers and used to the negotiating in the work day world. The flip side is that the daily routine is harder on a 42 year old body than on a 22 or 32 year old one. Fatigue strikes sooner and hits harder. We get hungry, and the one thing we're constantly reminded of is we can no longer eat anything and not gain weight.

What'sYour BMI?

Short for body mass index, which can be an important indicator of health. If yours is too high, you're at risk for developing certain diseases.

It Never Hurts to Break a Sweat

I'm no fitness expert but any kind of aerobic activity that makes you break into a
sweat can keep you in shape
and up with your kids. You start slowly and work into keeping your heart rate up for at least twenty minutes, in a range appropriate to your age. If step classes are not your thing, just some time on a treadmill, exercise bike or swim in the pool will do the trick.

The most effective workouts are done at a lower intensity for a longer duration of time. If you exercise too hard you don't burn fat, you burn glucose, or sugar.

Having a little trouble getting inspired?

Joining a health club is a perfect way to work out and catch up on some reading. Most clubs provide around two hours of free or minimum cost child care . The kids get some playtime and you get a well deserved break.

Getting Strong

The biggest advantage to lifting weights is building more lean muscle mass. The more muscle you have the, more efficiently your fat burners work. Muscle weighs more than fat, but clothes fit better because your body is tighter. It's great to feel strong, and helps when carrying those three and four year olds around. Weight lifting also helps prevent osteoporosis. It's never too late..Gypsy was over fifty and a grandmother, when she started pumping iron.

Gypsy writes,"when we are young we look for the ideal body.As you mature you realize that though the body can't be perfected, it can be changed. Nothing you do will keep your body in a permanent state. Your body will change no matter what you do. If you are overweight and out of shape you can change that with a good workout program. If you "feel weak and want to get stronger a weight lifting program can help you on your way."

Maybe you'd rather stay home

Exercise videos are another way to go. It never worked for me, the refrigerator is too close to the TV. But some people like the privacy and convenience of working out at home. If you're having trouble choosing a video workout partner, never fear., the web is near. Reviews of popular fitness videos, including speciality tapes on strength training or working out during pregnancy are available online at Video Fitness. Have a favorite tape? Post a review and share your opinion with other fitness fans.

Summing It Up

The main thing is to do something physical and do it often. It helps with fatigue and can be an ally in the fight against depression. The better we feel about ourselves as older moms the more energy we have. As midlife moms we live in two worlds. One where our kids play and grow and we run around doing all the same things women in their twenties and thirties are doing.

In the other, life is passing on the inevitable changes in weight and energy level that go along we getting older. If age brings wisdom, then it seems wise to optimize on our good health while we have it. Our kids can keep us young, and we can keep ourselves in shape.

Double Your Cuddling Pleasure

2009-10-25T11:31:00.000-07:00

Twins being carried together in one sling.

Place the first twin in the infant semi-recline position (head at rings end), then put the sibling in the nursing or cradle position (head opposite rings end).

Babies lay with legs twined.

Babies can also both be carried side by side in the belly carry position. Legs can either be inside or outside the sling, depending on the babies' sizes.

If carrying both twins is too difficult, carry the highest need twin, leaving your hands free to carry or push the sibling in a stroller.

Some adventurous (and strong!) parents carry their twins in separate slings, one sling across each shoulder with the babies in a hip carry position.

What is fifth disease and can I pass it on to my unborn baby?

2009-10-24T12:02:00.000-07:00

My son's day care has called and said there has been an outbreak of fifth. I'm 5 months along and need to know if this can give my baby any problems.

Despite the best intentions, pregnant women get sick. Having young children at home can make it almost impossible to avoid catching a bug. Most infections rarely have any effect on pregnancy; however, some can be serious. Fifth disease is one of these. Besides affecting the mother, this infection can cause serious illness in the newborn. But thankfully that's rare. So take a deep breath and read on.

Six childhood illnesses present with a skin rash. The first four are scarlet fever, measles, rubella or German measles, and roseola. Next came Erythema infectiosum commonly known as fifth disease or 'slapped-cheek' because of the fiery red rash that erupts on the cheeks. Fifth disease is caused by parvovirus B19. It's a common infection, and by age 15 about 50 percent of children have had it. Infection also occurs later in life so that by old age over 90 percent of people are immune.

Fifth disease can be mild or serious depending on one's health and immune status. In healthy children, infection is usually mild and brief, often causing no symptoms at all. The rash can wax and wane over a few weeks time and may reappear after exercise. In adults, especially women, about half of those infected experience joint pain and stiffness as with arthritis. Fifth disease can be even more serious for someone with a weakened immune system (from medication or illness) or a blood disorder such as sickle cell anemia.

Outbreaks of fifth disease are more common in late winter, spring and early summer. The virus lives in respiratory secretions in the nose and throat and is spread by close contact. But not everyone who is exposed to the virus gets infected. In school outbreaks less than 50 percent of children become infected. Among family members or household contacts, the odds of acquiring the illness are about 50-50.

Infection can also be transmitted by blood or blood products, or across the placenta during pregnancy. If a pregnant woman develops fifth disease, she runs a one in three chance of passing the infection to her baby. In a study of 618 pregnant women who were exposed to the virus, only half of the women were susceptible to infection and only 52 women became infected (Harger, J. Prospective evaluation of 618 pregnant women exposed to parvovirus B19: Risks and symptoms. Obstet. Gynecol. 1998;91:413-420).

How the virus affects pregnancy depends largely on the timing of infection. When infection occurs in the first trimester miscarriage is common. Birth defects can also occur. In the second trimester the immune system is still immature and infections can be serious. In rare cases (3 percent) it leads to heart failure and a condition known as hydrops fetalis or stillbirth. Infections in the third trimester can be easier on the fetus because their immune response is more developed. Women who get this infection during pregnancy are followed closely with frequent ultrasounds to keep an eye on the developing baby.

The odds are in your favor, but it's important to be on the safe side and check things out. If you think you've been exposed to fifth disease, get a blood test to measure your antibody levels and see if you're immune. Only women who have never had the infection, and have no immunity, can pass the infection on to their baby. While infection during pregnancy can lead to problems, in most cases it does not. -- June 5, 2001

Wishing you health,

How Much Weight Should You Gain?

2009-10-24T11:28:00.000-07:00

There was a time when women were advised to gain 15 pounds or less during pregnancy. Today, that seems like a nearly impossible feat and it is now recognized that such a small weight gain does not sufficiently provide the nutrients a baby needs for good health.

Although pregnancy is not the time to diet, it is also not the time to pile on excess pounds - neither extreme is good for mother or baby.
That's why most physicians recommend a total weight gain of 25 to 35 pounds. The weight gain during pregnancy should come from nutritious food sources rather than junk food or sweets that provide high calories with little nutritional value. Expectant mothers should eat lots of fruits and vegetables as well as low-fat dairy foods.

How to Wear a Sling: General Instructions

2009-10-24T11:26:00.000-07:00

Wear the sling as snugly as is comfortable:
In any of the baby wearing positions, your baby should rest just where he/she would be if you were holding him/her in your arms. This is best accomplished by tightening up the sling as snugly as is comfortable as soon as the baby is positioned within it. Keeping the sling snug protects your back and will be more comfortable for you and your baby.

If you cannot tighten the sling enough to be comfortable:
Than the sling is too large for you and you may want to order a smaller size. In the case of one small and one large parent, order the sling to fit the larger parent comfortably. Have someone who is handy at sewing open the seams at the ring end of the "side channels" and remove a few inches of the batting of BOTH channels. This will give the smaller parent a longer "tail" to tighten through the rings to permit a proper, comfortable, and safe fit for you and your baby.

1. Buckling/unbuckling the sling

Bring the "tail" up through both of the rings.
Loop the tail back over the bottom ring.

For maximum safety, the tail should not be adjusted below this point.

2. Putting on the sling (wearing on the left shoulder)
Hold the sling with your left hand, with the rings in front and the tail hanging down.
Slip your right arm and head through the sling as if you were wearing a purse or briefcase with the strap diagonally across your chest.
Position the sling so that the thick pad is on your left shoulder with the rings positioned about where you would pin a corsage, with the tail hanging down.
To wear on your right shoulder, just reverse directions.

3. Adjusting the sling

To tighten:
Support the baby's weight with one arm
Pull down on the tail with the other hand to snug sling to desired tightness
To loosen:
Pull up on both rings while pushing down slightly on the sling's hammock portion. (With older/heavier babies, the baby's weight alone may allow the sling to loosen when and only when the sling is unlocked.)
When you let the rings go, the sling will lock into its new position.

Maximizing Your Chances of Getting Pregnant

2009-10-24T11:23:00.000-07:00

If you're like most people trying to get pregnant, you probably remember the years of hassling with birth control and all that entailed-the diaphragms that flew across the room when you attempted to insert them, the condoms that broke at the peak of lovemaking or the pill that caused you to balloon in weight. In fact, you may have even experienced sleepless nights worrying about whether you had accidentally become pregnant, even though you used birth control consistently.

Yet here you are, years later, perhaps bemoaning the fact that you spent so much time and energy trying to avoid pregnancy, only to discover that it may not have been so easy to get pregnant, after all. For some couples, getting pregnant may indeed be difficult. But for many, it can be as simple as learning how to optimize your chances of conception by identifying when your combined fertility is at its greatest. Surprisingly, the chances of a typical couple of proven fertility conceiving in any one menstrual cycle is no higher than about 25%. But you can increase the chances dramatically by identifying the optional time to try.

While most would acknowledge the great benefits derived from advances in medical technology, there are drawbacks. One is that people are often led to believe that the most efficient and only way they will be able to get pregnant is though invasive procedures. Not only is this often untrue, it can also be counterproductive. Modern methods can ironically impede or delay the very pregnancy they were designed to aid (For example, Clomid tends to dry up cervical fluid, and artificial insemination may be inappropriately timed.) Today, there are countless ways to diagnose and treat so-called infertility. But if you think you might face a fertility problem, Fertility Awareness Method should always be the first step in the pursuit of pregnancy.

When trying to get pregnant, dispense with all the misinformation well meaning friends and clinicians seem to perpetuate. If you've read this book in sequence, and didn't sneak a peak at this chapter first, you should already know that there are a number of truths about fertility which differ from the myths you've heard.

Fertility Truths

1. A normal cycle is not necessarily 28 days; it ranges from about 24 to 36 days. It varies from woman to woman as well as within individuals.
2. You can ovulate as early as Day 8, and as late as Day 22 or beyond. The point is that women don't necessarily ovulate on Day 14.
3. Your most fertile day cannot be determined by your temperature. In fact, most women don't even experience the "temperature dip" that they've often been told to look for.
4. You are not most fertile the day of the rise in temperature, either. In fact, by the time the temperature rises, it's usually too late-the egg is already gone.
5. The key to identifying your most fertile phase is through cervical fluid, and not waking temperatures.
6. You don't need to stand on your head for half an hour after making love in order to get pregnant! If you are timing intercourse at the most fertile time, the sperm will swim up through the cervical fluid rapidly, regardless of what position you are in.
7. How often you should have intercourse during your fertile phase (i.e., every day or every other day) is a function of the combination of your partner's sperm count and your cervical fluid. It's not a hard-and-fast rule that applies to all couples alike.
8. Both men and women are equally likely to have a fertility problem. In other words, if a couple has trouble getting pregnant, one cannot assume it's automatically the woman's problem.

Why Some Women Are More Fertile Than Others

Even being armed with accurate knowledge doesn't necessarily quarantee a timely pregnancy. If it is taking longer than you had anticipated, probably the last thing you want to hear are the annoying cliches of well-meaning women about themselves:

"They just call me Fertile Myrtle."

"He just has to look at me and I get pregnant."

"I've gotten pregnant on every method of birth control (giggle, giggle). I guess I was just destined to be a mom."

Actually, there are several reasons why such women do indeed tend to be more fertile than others. In addition to the obvious fact that their reproductive organs are healthy, they may have a long phase of extremely fertile-quality cervical fluid, providing them more opportunities to get pregnant. Also, women with short cycles tend to ovulate more often, which means that they have more fertile days in a given year. But even though these women have a biological head start, you can certainly level the playing field by charting your cycle.

Applesauce Ice Pop Teether

2009-09-30T09:14:00.000-07:00

I put baby food into ice-pop molds and freeze. They are wonderful for babies who are teething and can also help to cool baby down during the hot weather. I would suggest using bananas or applesauce.

Later-age pregnancy: Preparing for the happy, healthy event after 40

2009-09-30T09:11:00.000-07:00

If you're in your 40s, your chances of getting pregnant are around 50 percent. If you've had no luck getting pregnant naturally, you can increase your odds of carrying and delivering a baby to about 10 percent with infertility treatment. But the whole issue of infertility treatment is another story. Before you check into the possibilities of getting pregnant, check out your health.
Although most older mothers (older than age 40) have uncomplicated pregnancies and healthy babies, you're at higher risk than younger women for complications.

Facing chromosome abnormalities

One of the biggest issues for older mothers is the risk of having a child with chromosome abnormalities. The most common is Down syndrome, a condition that causes mental retardation and defects of the heart and other organs. While your risk of having a child with Down syndrome is relatively low — only about 1 percent at age 40 — it's still greater than when you were 20.

There are, however, two prenatal tests — amniocentesis and chorionic villus sampling (CVS) — that detect chromosome disorders. Both tests carry a slight risk of miscarriage. If your test findings are abnormal, you'll be faced with the difficult decision of whether to continue or terminate the pregnancy.

Taking care of you

Diabetes and high blood pressure are more common in women in their 40s. Diabetic mothers are at greater risk for pre-eclampsia, preterm delivery, placental problems or stillbirth. Women with diabetes are also more likely to have a child with poor fetal growth or birth defects. Blood pressure also normally rises during pregnancy, which can worsen an existing condition, putting you at risk of seizures or stroke.

Even if you don't have diabetes or high blood pressure, you have an increased chance of developing pregnancy-related diabetes (gestational diabetes) as well as pregnancy-induced hypertension (PIH). Both gestational diabetes and PIH increase the chances of eclampsia, a complication characterized by high blood pressure, swelling of your face and hands and protein in your urine. Eclampsia can impair your nervous system function, leading to seizures, stroke or other serious complications.

Both conditions occur infrequently and complications are rare. Gestational diabetes is controlled with diet and exercise (and insulin injections for about 15 percent of women). PIH is treated with bed rest and close monitoring of your condition as well as the baby's, both during pregnancy and delivery.

Other concerns

Your chances of having twins or triplets also goes up as you age, even without infertility treatment. As an older mother, the possibility of multiple births is riskier to your health as well as the babies'.

Your chances of cesarean delivery are also about 40 percent higher than a younger woman's. Although a cesarean delivery is riskier than a vaginal delivery, most are uncomplicated and require only a slightly longer hospital stay and recovery time.

Planning ahead

Here's what you can do to improve the health odds for you and your baby:

Control existing health problems such as high blood pressure or diabetes.
Lose weight if you're overweight. Women who are overweight when they get pregnant are more likely to develop problems during pregnancy.
Take prenatal vitamins containing folic acid before getting pregnant to help prevent neural tube defects such as spina bifida, a condition in which the tissue over the baby's spinal cord doesn't close.
Learn about your health risks and the diagnostic tests you may want to have to detect chromosome abnormalities.
The benefits of waiting

Although later-age pregnancy can put you at higher risk for a number of health complications, there's an upside. As a potential older mother, you may be more mature, realistic and dedicated to the idea of having a baby than a woman in her 20s. You've probably also given a lot of thought to the changes a new baby will bring.

Sheri and Steven: vaginal delivery, epidural, episiotomy

2009-09-30T09:08:00.000-07:00

The day I found out that I was pregnant was a day of mixed feelings. I had been pregnant once before, and it had ended in a miscarriage. On November 11, 2008, I went to have a pregnancy test done. I was shocked to learn that I was expecting. I had been told when I was 16 that I would never be able to have a child because of the amount of damage that I had suffered "down there". I did everything like I was supposed to and made an appointment with the nearest and only OB on the island.

I had for the most part an average pregnancy. I went to the emergency room at nine weeks pregnant for vomiting blood. The nurse told me that it was normal and told me she didn't know why I even came to the hospital. After giving her a colorful piece of my mind and making a few people blush, the doctor came in to give me a shot in the butt and some Maalox mixed with lidocaine. I was also told that I had an environmental illness that caused me to have severe headaches and vomiting with some of them. I was warned to stay away from aerosol cans and powders for carpeting, etc, during the course of my pregnancy. After about five months that subsided.

I began showing quite early, at two months to be exact. My first appointment with the doctor wasn't until the beginning of December, three weeks after I found out that I was pregnant. On November 15, I began bleeding vaginally, and became very stressed out. I called the doctor and she set up an appointment for me to have an ultrasound done. I didn't drink enough water so the baby didn't show up on the screen. That only served to scare me even more. The doctor gave me the same explanation I just gave you and that set my mind at ease.

The next few months were uneventful. At around seven or eight months pregnant, my boyfriend, Sean, and I decided to sell everything that we owned and moved 2200 miles away to be with his family. I found a new OB and began seeing him once a week. My first appointment was on the 24th of May. On June 10, he ordered me to have NSTs done once a week until I delivered. He listed me as high risk because I was a smoker. (I tried to quit, but was only able to cut down.) I had a bio-physical profile done which included an ultrasound. I found out that I was carrying a baby boy. He was more than willing to flash us those, but wouldn't show his face. (I'll explain that later.) Every week his heart rate was 140 beats per minute, tight where it should be.

I lost my mucous plug on June 20. I wouldn't end up delivering Steven until July 19. In the beginning of July my doctor told me that I was dialated to 2 cm and was 75% effaced. I was so happy. I was ready to have this baby. I got his opinion on inducing labor and told him my stand point on it. I requested an epidural when I first began seeing him but had started to change my mind. I had heard horror stories about them. He told me that it was my decision and I would be able to change my mind up until the delivery room.

The next week I saw a different doctor because mine was out of town on vacation. He checked me for dilation and told me that I wasn't dilated at all or effaced. I asked him if he was sure because my doctor had told me otherwise. He looked at my chart and changed his mind. I got another appointment for the next week and went home. A few things he said upset me greatly, and the next week I reported him. I was told that if I could hold out until the 16th I wouldn't have to have him deliver my baby. I was in luck.

On July 19 at about 1 a.m., my back began to hurt, and I was having pain in my lower abdomen. I thought that it was just Braxton Hicks and continued to crotchet. This went on for two hours. I decided to try folding laundry and take my mind off the pain. It didn't work! Finally at about 4:30 I decided it was time to get some sleep. I figured that if I was really in labor that I would wake up long before the baby was ready. I wasn't going to have him in my sleep. I woke up at 10:30 and had my morning cigarette. While smoking I had an unbearable pain in my back and lower abdomen again. Still thinking that it was Braxton Hicks and nothing more, I didn't pay attention and tried to go about my normal activities. I noticed that the pain was coming every 10 minutes. I sat down on the couch and began to time them - every 10 minutes for two hours. Then, I only had back pain, no abdominal pain. I thought it was over but then they began coming every 7 minutes and boy these hurt even worse than the last ones.

At 12:45 p.m. I decided to call my doctor's office and speak with a nurse. I explained everything that had happened and at first she told me to see if changing positions would help. I told her that I had already tried that, right as she was getting my chart. She saw that I was 4 days past my due date and told me to go to the hospital. My soon to be sister-in-law, Wendy, was awake by now and was sitting on the couch listening to what was going on. She called her babysitter and left the kids with her. It was lunchtime and everybody was on the highway. A 20-minute drive took almost an hour. I finally got to the hospital at just before 2 p.m. I left my overnight bag at home because I still did not believe that I was in labor.

I was assigned to my room and admitted to the hospital. I had to be put on a pitocin drip because my contractions weren't strong enough for labor to proceed. After all the paperwork was filled out, I was finally given something for the pain which had become quite bothersome to put it lightly. The nurse told me that I was going to break the bedrails if I didn't relax and let them come. I was in too much pain to say what was on my mind. The demoral was finally starting to take effect when she told me that I was really in labor and that it was safe to call Sean and tell him to come to the hospital. Wendy told him not to leave work right then. I was going to be there a while. I was only dilated to 3 cm. Sean got to the hospital right as they were getting ready to give me an epidural. Wendy left the room and came back in with her husband. This was around 5 p.m. I had begun to notice the epidural taking effect a few minutes later. Within 20 minutes I was completely numb except for my big toe on my left foot. I kept waiting for the nurses to come in and cut me off but to my surprise they never did.

Wendy called a few people and while I was awake I talked to a friend. I dozed in and out for the rest of the time. I kept apologizing for falling asleep. The nurse came in at 8:45 to check me and told everyone except Sean to leave the room. I was ready to have the baby. I was a bit worried that I couldn't feel anything still. The doctor came in and took a seat between my legs and dove under the sheet. Sean watched as he told me to push. Nothing was happening so he told me to grab my knees. I was so numb that I couldn't move my legs. The nurses had to pick them up and give them to me. After less than 10 minutes of pushing, he told me not to push anymore. That was no problem. The doctor cut me all the way down. Steven had a big head!!! The next thing I knew, I had one big push left and felt a gush between my legs. I thought I had wet myself! The doctor announced that I had a baby girl! I asked him if he was sure. He corrected himself and then said the four most horrible words he could have ever said. "We have a problem."" My son was born with a cleft lip and palate. This shot down all hopes of breastfeeding. I began crying uncontrollably for the next 20 minutes. The doctor cut the cord and Steven was officially born at 8:56 p.m. on July 19th 1999.

Steven was taken to be cleaned up, weighed and measured. He was brought back to me for a few minutes and Wendy came in with her husband. They weren't told in the waiting room what was going on so they were quite surprised to see me so upset. I thought that it was something that I had done. The doctor assured me that it was not my fault and that he had called in a plastic surgeon to look at my son. Steven spent the first night in the nursery, so they could keep an eye on him and make sure that he ate okay. The cleft did not affect his eating or breathing, and after the 48 hour wait in the hospital was up, I was allowed to take him home. I still wanted him to have breast milk so I expressed milk until I was no longer able to keep up. Steven weighed in at 8 lbs, 2 oz. and 20 inches long.

Steven is truly the love of my life and is the most beautiful baby I've ever seen. Steven had his surgery to repair his lip at three months. He's now five months old and is doing great. As for me, I had a slight bout of postpartum depression. I missed being pregnant and sleep!! A word to all expectant mothers who read this. Accept any help that you can get with a new baby. I tried to do everything myself and broke down crying within the first week I was home. I thought I would be a bad mother if I let my son cry for a few minutes to go to the bathroom or to take a shower, and was afraid to ask anyone to watch him for a few minutes. I'm still leery about leaving with a sitter, but have gotten better.

Recycling Baby Toys

2009-09-30T09:06:00.000-07:00

Is your baby bored with the rattles and toys that charmed her two months ago? Try recycling them. Decorate a clean, empty wipes box with non toxic paint and markers. Put the toys inside and watch your baby have fun opening the box and finding new treasures to play with. This helps babies learn how to open and close, take things out and put them away.

Take Off the left over weight 2

2009-09-30T08:45:00.000-07:00

Part 2 of Take Off the left over weight article deals with what kind of exercise you should begin to do after your baby is born. She has some great tips on the "slow and steady method" of getting back in shape.

A Little Advice

Don't expect to perfect your weight loss plan right away. If you've been making healthy eating choice and exercising regularly for a week and you have one moment of weakness where you indulge in a piece of chocolate cake..it's okay, as long as you realize that it is bound to happen now and again and that partaking in this indulgence has not ruined your efforts. At this point simply resume your healthy routine.

What Should I Do For Exercise After My Baby is Born

It is important to get the OK for exercise from your doctor. Make sure he /she checks the integrity of your abdominal muscles so that you know you are OK to start regular sit-up exercise.
Begin Pelvic Floor Exercise "Kegels" immediately to strengthen the muscles that support your bladder. Pull up and in as if to stop the flow of urine. DO NOT do this while you are actually urinating.
Begin abdominal isometrics to strengthen your stomach muscles "abdominal". Lye on your back with your knees bent up and suck in the stomach muscles.
Begin a regular stretching program to regain your flexibility.
Begin a regular strengthening program to build endurance and improve muscle tone.
Make sure to include cardiovascular exercise into your routine. Some examples of this are: walking, running, swimming ,dancing (around the kitchen with the baby).
Start slow and work up as you regain your strength..remember everyone is different and feels slightly different after delivering a baby. Listen to your body and follow its signals.

A Quiet Place to Nurse

2009-09-29T06:02:00.000-07:00

For comfortable nursing or resting at the mall, go to "upscale" stores such as Nordstroms, Robinsons-May, Bloomingdales, etc. and use their lounge areas adjacent to the restroom. They have quite nice areas for sitting and are away from the commotion and the toilets.

Adult Underpads for Changing Baby

2009-09-29T06:01:00.000-07:00

My husband came up with the brilliant idea to use disposable underpads (size regular) for the diaper changing table. They are sold at the drug store where adult diapers are located. The underpads are a great addition to your diaper bag as well!

Lisa and Stuart: 50 hour labor, pitocin, epidural, cesarean birth

2009-09-29T05:55:00.000-07:00

When I discovered I was pregnant with my son, my husband and I were overjoyed. We had tried to get pregnant for three years, which was disappointing and frustrating. I had already formed strong opinions about how I wanted my labor and delivery to go, and I was certain that I had complete control over the process. The birth plan I presented my midwife with stated that I wanted no pain medication and as little medical intervention as possible. This was my choice, right? We chose a hospital birth with a highly recommended midwife who has her office/home in Seattle. My due date was May 28, 2003 which was our fifth anniversary. We planned an intimate dinner close to home for the occasion given that we weren't certain we would make it. As it turned out, May 28th came and went as it did with most first time moms, and it wasn't until June 3rd that things got started.

I went to bed around midnight on Wednesday night and woke up about 2:30 am to pee and there was blood on the tissue. I knew it was my bloody show and I was extremely excited and a little bit scared. I kept Bruce awake for awhile and then he slept. I couldn't sleep. Around 3:00 am I started leaking amniotic fluid and started having contractions 10 minutes apart, then one per hour. At 5:30 am I called Sally, our midwife, and told her that my water had broken. Sally was scheduled to be out of town camping with her daughter's class from 8:00 am Thursday to 5:00 pm Friday. We assumed that she was going to have to miss the delivery. I was able to sleep a little bit finally and we woke up about 10:00 am. We went to breakfast at a restaurant nearby and we talked a lot about what we thought labor and delivery were going to be like. Every contraction was exciting but I got tired of soiling everything I put on.

At 1:00 pm we went to our scheduled prenatal visit at Sally's office. We were seen by Heika, a student midwife that was working with Sally. Heika was being evaluated by someone from the Seattle School of Midwifery. The person with her shared in our excitement at going into labor soon. Heika listened to the baby and told us that after my water had broken, we needed to go to the hospital for a non-stress test and a Group Strep B test every 12 hours to ensure that the baby was doing fine. We scheduled the appointment for 5:00 pm that evening, and Heika advised us to try some home techniques for getting labor started. We went home. Because there was a possibility that we would have to stay at the hospital if the Strep B test was positive, we packed for the hospital. I got a hold of my mother who was to fly in for the delivery and she scheduled a flight for 7:00 am Friday which would arrive at 11:15 am.

At 5:00 pm, we went to the hospital for the non-stress and Strep B test. We met FraNa who is Sally's backup midwife and who would be doing the delivery since Sally was going to be gone. We also met Patricia who is an intern midwife working with FraNa. She asked to observe my birth, and we agreed. Since the Strep-B test results would take about an hour, we decided to go to dinner. At 6:30 pm, we went to Cucina! Cucina! for dinner which must be the noisiest place on earth. It made the whole idea of being in labor very festive to be there, and we ate well. I told the waitress I was in labor and she screamed in delight. Bruce called about the Strep test and we were told we didn't need to go back to the hospital and that we could go home. While we were still at dinner, the contractions sped up to about 15 minutes apart. I was a little bit more excited, and we drove home.

By 9:00 pm, the contractions were about five minutes apart. I was definitely in labor now. I called several people to tell them. Bruce and I got in the shower and used the shower massager for about 45 minutes. I also started using my friend Liz Chalmer's book. (It is called "The Childbirth Kit.") The picture with the light lines against the green background is best - I imagine myself climbing up the straight side with the in breath and sliding down the diagonal lines with the out breath. By 10:30 pm I started using more serious coping techniques, and called Heika. I was still not quite ready to go to the hospital but the contractions were definitely getting stronger.

At 2:00 am I knew it was time to go to the hospital when I was anticipating that the ride there would be rather uncomfortable. We called Heika and decided to go to hospital. We arrived at the hospital at 2:30 am and a nurse checked me. I was 5 cm dilated and 80% effaced. They took me up to the labor and delivery area and I put on a gown and they ran a monitor strip on me and Heika checked me. It was pretty exciting that I had made so much progress. I got into the jacuzzi tub right away and stayed there for quite awhile. I think this is when we developed my coping ritual. I would hold hands with Bruce (or whoever else was closest) and do slow breathing through the contraction. I labored that way until 8:15 am when I was checked by Heika who found me at 7 cm dilated and 90% effaced.

This next section of time isn't too memorable. I guess I walked around, went through several contractions, and made progress. I think close to the next check I started to go into transition. I threw up and Heika called FraNa. At 10:15 am I was checked again by Heika and was found to be 8 cm dilated and 90% effaced.

I was starting to get discouraged by this point. When Heika checked me I was disappointed in how far I was and wasn't sure how much more I could take. I knew my mom was on the way and looking forward to her getting there kept my mind off the contractions a little. My mom got there at about 11:30 am. Curiously, I had been thinking that somehow she would make all of the pain stop. When I saw her I was so relieved that I burst into tears. I got back into the jacuzzi tub for awhile and Bruce and I did some nipple stimulation to try and get the contractions to be stronger. It didn't seem to help that much.

At 1:15 pm I was checked by FraNa and I was still at 8 cm dilated and 90% effaced. FraNa decided that the head was not straight-on to the cervix, so the cervix was not dilating evenly. We started trying different positions to try and help the head to get straight into the pelvis - rocking, knee-chest, rocking legs on rail, etc. Sometime around here, because my progress was slowing down, they decided to give me a bag of fluids to help hydrate me and give me some sugar for energy. They started talking about using some pitocin, but the contractions were so painful that I didn't think I could handle them. I told them that I would need pain medication if I had the pitocin. I think this is when my coping ritual started to include light breathing instead of slow breathing. Whenever the contractions got really bad, Bruce would really make me pay attention to him.

At 4:15 pm, after six hours at eight centimeters dilated, we decided to use pitocin and an epidural. The spiral of interventions begins. I was catheterized and an automatic blood pressure cuff were put on my arm. I remember being very sad as all of the tubes and wires were stuck into me. This is not how I wanted it to be. The doctor who gave me the epidural was there immediately and did the procedure very fast. My mom held both my hands and talked to me the whole time the doctor was doing the procedure. I sunk thankfully into sleep. After two hours, at 6:15 pm, I started to feel a lot of pressure and told the nurse. I was then checked by Heika (Sally had arrived), who found me to be fully dilated, and we started to prepare for pushing.

I was so relieved and excited. The hard part was over! I was really looking forward to pushing. I knew that I would be a great squatter. I told everyone to hurry up and get ready. At 6:30 pm I started pushing. After 30 minutes, the epidural was reduced so that I could feel the pushing. After 30 minutes more, the epidural was reduced again. Patricia (FraNa's student midwife) sat behind me to support me while I pushed in the squatting position. I felt really good and refreshed by the rest. I joked around with everybody. I waited impatiently for each contraction. After a few hours, my spirits flagged. We had been trying a lot of positions and the baby had not moved. I was in a lot of pain. I was unable to resist the urge to push. Sally was unable to determine the position of the baby's head. At one point, she put her hand between the baby's head and my cervix and tried to slide her hand around to see where his ears were. I screamed in pain. I was getting ready to give up.

At 10:30 pm I was given a big dose of some pain killer (don't remember which one) to reduce pain and let me sleep. Also, the pitocin was increased, to try to establish a stronger contraction pattern. I was grateful for the "cocktail" I was given. Between contractions, I slept. During the contractions, I breathed and thought about the fact that I would soon be offered a C-section. I was now desperate for this to end.

At 12:30am Saturday I woke up. The contractions were determined to be still not as strong as needed. By this time I was resigned to a C-section. I, as well as my husband and mother, were exhausted emotionally and physically. Although my baby has never shown signs of distress, I knew that it had been hard on him. I wanted him to come out.

At 1:00 am we started discussing options: 1) pump up pitocin even more, 2) push for an hour more and try vacuum extractor, 3) c-section. Everyone but Bruce and I left the room so we could make a decision. Bruce was so exhausted that I don't think he was completely lucid during this part. When discussing the three options, we were told that #1 and #2 are not given a very optimistic chance. I told Bruce that I was ready for C-section. At 1:30 am we told Sally we had decided on a c-section. Sally had bright lights turned on and cold water put on my face so I would be wide awake for the explanation and signing of the consent form. Dr. K., the physician who would perform the c-section, came in to check me, explained the procedure, and had me sign the consent form. A nurse came in and shaved part of my belly. Mom and Bruce and Sally and Heika and Patricia put on blue clothes.

At 2:00 am I was wheeled into the operating room, but then was moved out because of someone else needing an emergency c-section. The anesthesiologist gave me some extra zaps of medication to keep me comfortable while we waited. I tried to sleep during this time and waited for the C-Section. I think Mom and Bruce went to eat and rest and I dozed. At 4:00 am I was wheeled back into operating room. The operating team worked like clockwork. They turned the epidural way up and I started shaking very badly. The shaking was horrible and scary. I held Bruce's hand very tightly. They put an oxygen mask on my face. I felt a lot of pulling and tugging. I couldn't wait to see my baby! We hadn't had even a routine ultrasound so we had no idea yet if it was a boy or a girl until he was delivered. I tried very hard to relax but the shaking was making me very uncomfortable.

At 4:22 am Saturday morning, Stuart Aaron Copeland, 7 lbs 1 ounce, 19 inches long was born. My mother started exclaiming about the baby, and I asked if it was a boy or a girl. No one would tell me - they held him up for just a minute for me to see and then wrap him up. I have a son! My mother brought him over to us. I can't let go of Bruce's hand but I looked at the baby. Was that amazing little creature really inside of me? I begged for the shaking to stop and I was given a shot of demerol and became very drowsy. After closing me up, they wheeled me back to the L&D room.

At 5:00 am Sally started showing Stuart how to breastfeed. I was aware that it was happening, but was pretty out of it from the demerol. They then took Stuart to the nursery. I remember very little about this part. I have missed that precious first hour of my son's life. I slept for a few hours and then woke up when a nurse came in. She gave me a cherry popsicle. Bruce and Mom slept in the room. At about 10:30 am they moved me to the postpartum wing. Liz Chalmers came to visit that afternoon. What went wrong? Neither Sally nor Dr. K. could determine the position that Stuart was in my pelvis. When they got him out, he had a large bruise on the front part of his head. They think he might have been in a brow presentation in the "sunny side up" position. He was unable to progress through my pelvis because of this. Also, they are not sure why my contractions were so weak. It may have been exhaustion or there may have been an infection present in my uterus from my water breaking early.

When I was able to think about my birthing process a day later, I was overwhelmed with depression and grief. I had been through over fifty hours of labor and then had a c-section. I had thought that I had complete control of this situation and felt like a failure even though I was told over and over that I had done nothing wrong. I was completely traumatized by the amount of pain I had gone through and for years I cried every year on my son's birthday. I got angry when I read accounts of childbirth which "go perfectly" in which the author claims it was her "control over her emotions" and her "ability to be in tune with her body". I believe now that the person who feels that way has been a little lucky and has not learned as I have that it doesn't matter what you do - nobody has control over the birth process. Now that I am pregnant with my daughter, who is due on May 6th, 2009, I have a different perspective on this amazing process. I have much more respect for it and will allow it to happen in its own way.

A Place to Teach Toddlers to Pour

2009-09-29T05:50:00.000-07:00

I used the door of the dishwasher to teach my toddlers to pour drinks. If they spilled, it was okay, because the dishwasher door got cleaned up during the next cycle. Also the door is the right height for small ones to reach! Contributed by Crwltc.

Is My Breastfed Baby Gaining Enough Weight?

2009-09-29T05:37:00.000-07:00

A very common concern among newly breastfeeding mothers is whether their baby is gaining enough weight.

This concern is quite often borne of, or exacerbated by, their health care provider telling them that their baby is not gaining enough weight "according to the chart", or is, even, "falling off the chart".

Unfortunately, nearly all health care providers seem to be using the same old chart which has been around for decades, and which is based on the weight gain averages of babies who are formula fed! [Note: Remember that gaining more weight is not necessarily a good thing - i.e. it is not a "benefit" or "advantage" of formula that babies bulk up on it!]

Fortunately, there is a set of charts based on the weight gain averages of babies who are being raised on the food which nature intended for them - breastmilk.

Am I Making Enough Milk for My Baby?

2009-09-29T05:32:00.000-07:00

It is very common for new mothers to be concerned that they aren't producing enough milk for their infants. However, in reality, it is extremely unusual for a mother to not have enough (in fact more than enough) milk for their baby - that is how nature intended it, and indeed how it works!

The following are some typical reasons why new parents may be concerned that they are not producing enough milk, or that their baby is not otherwise getting enough milk:

The breasts don't feel full.

Fullness or lack thereof is no indicator of amount of milk. Particularly after the first few weeks, the breasts can always be soft, and not "feel full", and yet the supply will be just fine.

Baby cries or otherwise acts "hungry" after breastfeeding, and/or baby wants to breastfeed for hours on end.

These are not necessarily symptoms of hunger, let alone low supply. Your baby may have other reasons for crying (gas, "colic", a regular fussy period), and other reasons for nursing for long periods of time (comfort nursing, having a growth spurt and need to build supply to meet new demand).

Not much milk produced during pumping sessions.

Babies are generally much more efficient at getting milk out of a breast than are even the best pumps. Many women report only being able to pump an ounce or two, or less, at a sitting, while their babies routinely are able to get 7 or 8 or more ounces (determined by weighing the baby before and after nursing).

If your baby is wetting several diapers a day, is pooping, and is gaining weight (after the first week of life, as breastfed babies typically lose weight the first week, then get back to their birthweight by the second week, and start gaining from there) then your supply is probably just fine!

Also, realize that if you are using disposable diapers, the diaper may be wet and you may not realize it! So if your baby's disposable diaper doesn't seem wet, really press on it (or sniff it) to find out whether it is wet before you panic!

If your baby is not wetting diapers, pooping, and gaining weight, and you really are dealing with a low supply problem, the best way to build supply is to let the baby nurse, nurse, nurse, and nurse some more. Milk production is based on supply and demand, and the greater the demand, the more milk is produced.

Note that supplementing with formula, or solid food, will undermine one's supply! Don't do it, if you can possibly avoid it! Generally, it is highly advisable, in order to make it work well, to only breastfeed (no bottles) for at least the first six weeks. This is because it takes about this long to really get breastfeeding going well, and to firmly establish your milk.

Feeding formula in the early months (and, again, especially during that first 6 weeks) will almost surely undermine your own milk supply, not allowing it to really establish, and even if it does, diminishing it, quite possibly to the point of it being negligible (as your body will think that your baby is weaning).

It also is bad because the baby can develop "nipple confusion". It is much easier to get milk/formula out of a bottle then out of a breast, so often a baby will become unable/unwilling to nurse from the breast once it gets used to a bottle.

It is important to understand that it is extremely rare that a baby would need to be supplemented with formula, absent a medical reason that either mother or child could not keep up the nursing relationship. Your body will make as much milk as your baby needs, it's a simple and effective design - the more your baby nurses, the more milk you produce, and vice versa.

Unfortunately, many health "professionals", including lactation consultants, will advise a new mother to supplement. Be wary, be informed - just because a person works in the medical or lactation field does not make them an expert! [Note: Many lactation consultants are very good, but many are not - if you have doubts about advice you are receiving, always get a second opinion. A very good resource for this is your local La Leche League leader.]

Many many new mothers make the mistake in thinking that because their baby will suck down formula after nursing, they are still hungry.

In reality, babies, especially younger ones, want to nurse for a long time, not eat for a long time. Many newborns nurse for up to an hour at a time, every couple of hours! That is how your supply gets established!

Even if one replaces nursing feedings with pumpings, that will still undermine supply. Pumping does not produce ('demand') as much milk from the breast, so the breasts will cut down on production. Don't do this either, again, if you can possibly avoid it. Pumping between demand nursings can help a little, as it is then increasing, by a little bit, the amount that baby is naturally demanding.

Again, if you can possibly take the time to take a day or two and do nothing but hang out with the baby, and let the baby nurse whenever and for as long as baby wants, your supply should be just fine. Taking fenugreek, and eating oatmeal, and drinking plenty of water can be additional insurance, but the demand nursing is the main thing.

Finally, if you really have already done all of this, and you still feel there really is a supply problem, have your doctor run a thyroid test. A thyroid problem can severely impact supply, and well before it becomes otherwise apparent.

How Long Should I Breastfeed My Baby?

2009-09-29T05:28:00.000-07:00

Most people know that breastfeeding a newborn is very important because the mother produces a substance known as colostrum during the first few days of life; the colostrum, the precursor to milk, is extremely rich in antibodies, as well as being custom made for that mother's baby.
Most also know that it's "good" to breastfeed a baby for "a few months", but, sadly, that is as far as the breastfeeding knowledge of many goes.

In fact, babies should be exclusively breastfed for approximately the first 6 months of life. Solids should be introduced at whatever point after six months the baby starts showing a serious interest in solid food (indicia include grabbing food off others' plates, staring intently at others eating, and making chewing motions while starting at others eating).

Even after the introduction of solids, babies should be breastfed for at least the first full year of life. Even the very conservative American Academy of Pediatrics recommends "that breastfeeding continue for at least 12 months, and thereafter for as long as mutually desired." (See cite to site below.)

The World Health Organization recommends that children should be breastfed up until two years of age, or beyond.

Another Use for Bath Rings

2009-09-25T08:05:00.000-07:00

If you want to conserve water and are also having a difficult time getting your baby's bath ring to "suction" onto your tub because it's textured, try putting it in the infant tub and then adding water. I use method for my six-month-old daughter, and it works great because she is still able to sit (which she loves), but in a smaller area, and the ring "stays put" in the infant tub. Her tub toys are also close at hand and not "drifting away"!

Take Off the left over weight

2009-09-25T07:56:00.000-07:00

You've had the baby..he or she is everything you've ever wanted. There's
only one problem, nine months of eating for two left you with a little extra
baggage. How do you get that weight off? We introduces
the way to be with your baby and lose weight too.

Remember the Following

It took nine months for you to gain this weight and although every woman is different, it's not abnormal for it to take nine months or more to get it off. Lose the weight for yourself so that
you look and feel the way you want to and stay healthy. T ry not to set unrealistic goals for your weight loss plan. Accept that is is going to take time. Start thinking about losing 5 pounds in
2 months and not 50. We all make deals with ourselves. Usually it's something like ...I'll eat better when the baby sleeps through the night or after this meal I'll start eating better. Try not to do that, and....

Remember this is a life change that needs to fit with your lifestyle.

What Do I Need To Do to Eat Right

Eat breakfast. You neeed the nutrients it provides to get through your day with more energy. T his is especially important for nursing moms.
Eat from all the food groups. A balanced diet is always best.
Eat lots of fruits and vegetables. They are low in calories and high in nurtients.
Try not to exceed the recommended daily allowance of cheese meat or salt.
Drinks lots of non-caffeinated beverages. W ater, herbal tea, lemonade or juice are good.
Eating three times a day provides a steady supply of energy.
Consult your doctor about what vitamins you should be taking. This is especially important for nursing moms.
Try not to count calories, eat in moderation instead. Dwelling on what you ate will likely be a cause of furstration..and we all know how many of us deal with frustration..BY EATING.

Babes & Keychains: A Compromise

2009-09-25T07:51:00.000-07:00

Since our son (like most babies) prefers real keys over the toy key rings, I made him his own key chain with old keys we had no use for anymore and a few of the soft key fobs. Now we don't have to give him our keys to placate him -- and fight him to get them back. They're easy to clean too_ just slip them into the silverware holder in your dishwasher!

Parenting at a later age

2009-09-25T07:44:00.000-07:00

Ask yourself some tough questions — Before you decide a new baby is right for you, ask yourself if you are emotionally and physically strong enough to handle raising a child?
Have realistic expectations — Babies mean change. Be prepared for what may be a great adjustment in your lifestyle. Ask yourself how a baby would fit into your current lifestyle, and how flexible could you be?
Be prepared that, no matter how much reading or preparing you do, you can't control or predict every aspect of your child's development.
Seek out a support system— Older couples may have less support from extended family because their own parents are even older (or may no longer be living). Meanwhile, many of their friends may already have raised their children. If you have other responsibilities — older children, parents or relatives to care for, a business to run — you may have even more reason to seek support from others going through similar phases in life. Seek out people who are willing to listen as well as offer advice.
Exercise, eat right, and take time for yourself— As you age, your body's ability to bounce back after being up all night with a child or working all day and then coming home to parent may change. It's important to balance good nutrition with aerobic activity to increase your energy level while maintaining good health.
"Also it's important for parents who may feel overwhelmed with their new responsibilities to set aside some time just for themselves and for their relationship," notes Laura T. Evans, co-founder of the National Parents Association in Val Paraiso, Ind., a volunteer organization that provides support and information for parents.
Make long-term financial plans — It's very possible you may be in your retirement years at the same time you have the greatest expenses of raising a child. By planning ahead, you may provide a more secure future for your family.
Be prepared for other people's reactions— When a 63-year-old woman recently gave birth for the first time, it received a lot of attention. People generally have children when they are in their 20s and 30s. That's considered the "ideal." And while people may be more accepting of older men having children, they may not feel the same about older women. You may face sex and age discrimination and being prepared with a straight-forward but non-defensive response may make things easier.

Challenging society's notions of the ideal parent

Bernard points out that advice she gives to middle- and later-age parents is really no different from what she gives to younger parents, and that there is no guarantee any parent will live to see his or her child into adulthood. And she reminds parents that once the baby arrives — despite any reservations they might have once had — they probably won't be able to imagine what their life was like before their new child.

She challenges friends and families of later-age parents to be accepting, empathetic and supportive. "As we see more and more nontraditional families, it's important that society as a whole begin to challenge the notion of the 'ideal parent'," Bernard says. She adds: "Parenting at 20, 40, or even later takes the same basic things: nurturing love — and a sense of humor."

Building Baby's Intelligence: Why Infant Stimulation is Important

2009-09-24T07:43:00.000-07:00

Recent advances in brain-imaging techniques have proven what researchers have said for over twenty years: an infant's environment has a dramatic affect on brain development.

In the first years of your baby's life, the brain is busy building its wiring system. Activity in the brain creates tiny electrical connections called synapses. The amount of stimulation your baby receives has a direct affect on how many synapses are formed. Repetitive stimulation strengthens these connections and makes them permanent , whereas young connections that don't get used eventually die out.

These first years are a very important and pivotal time for a developing young brain. This intense period of brain growth and network building happens only once in a lifetime. We as parents have a brief but golden opportunity to help our babies stimulate the formation of brain circuitry. Here are some fascinating facts that researchers have discovered:

Babies have a biological need and desire to learn
The foundational networking of the brain's synapses is nearly complete after the rapid brain development of the first 3 years.
The more stimulating experiences you can give your baby means the more circuitry that is built for enhanced learning in the future.
Babies have a definite preference for high contrast images.
The amount of connections in the brain can increase or decrease by 25 percent depending on the environment and stimulation.
Visual stimulation can produce developmental advantages including enhanced curiosity, attentiveness and concentration.
Your baby's best toy is you! Interact with your baby as much as possible!

Things you can do to stimulate your baby:

Love. First of all, remember love and affection are very real needs. Your baby is never trying to manipulate or control you, she simply has a biological need for your love...never deny her your tender affection. This unconditional love also creates a strong self-esteem and increased development of brain circuitry.
Talk to your baby often with a kind voice, a wide range of vocabulary, and a lot of expression. Your voice is her favorite sound (she has heard it since before she was born).
Respond to your babies requests (interpreted cries) without hesitation. This teaches her that she can communicate with other people and gives her a strong sense of trust and emotional stability.
Touch your baby. Researchers discovered that premature infants that were massaged grew faster, cried less, and were released earlier from the hospital than those who weren't.
Encourage imitation. Your baby is constantly analyzing you and figuring out ways to mimic your voice and facial expressions.
Let your baby experience different surroundings: go for walks, take her places, show her the sites!
Let your baby explore different textures and temperatures (not too extreme, of course). Provide a safe environment for your baby to explore. She also needs time to discover things for herself.
Read books: even though your baby can't follow the story, she loves the pictures and the sound of your voice.
Play music for your baby (Mozart's music has been found to stimulate the same neurons in the brain that are later used for mathematics).
When you get frustrated because your baby keeps dropping objects or pours the box of cereal on the floor, remember, she is trying to figure out how the world operates.

Some advice on sex during pregnancy

2009-09-24T07:39:00.000-07:00

Should you be concerned about having sex while pregnant? we asked medicine specialist, Diana R. Danilenko-Dixon, M.D., for advice for expecting couples.

We: Is it OK to have sex while you are pregnant?

Dr. Danilenko-Dixon: Yes, in most cases. If your pregnancy is proceeding normally and your health care provider has not told you that you're at risk for premature labor, incompetent cervix or placental problems, your lovemaking can proceed well into the third trimester. If you're at all uncertain whether you're at risk, ask your obstetrical care provider.

We: Could intercourse result in a miscarriage?

Dr. Danilenko-Dixon: Many expectant parents are primarily concerned that intercourse will cause a miscarriage, particularly in the first trimester. Most miscarriages during this time, however, are unrelated to sexual activity. They commonly result from genetic defects in the developing fetus.

We: Can having intercourse harm the baby?

Dr. Danilenko-Dixon: No. A penis does not physically contact the fetus, which is well-protected by uterine muscle and amniotic fluid. The cervical mucous plug prevents bacteria and semen from entering the womb. However, if deep penetration causes pain, it should be avoided.

We: Can orgasms result in premature labor?

Dr. Danilenko-Dixon:Orgasms may cause uterine contractions. However the vast majority of studies indicate that in a normal pregnancy, orgasms (with or without intercourse) do not lead to premature labor or premature birth.

We: Is there any time doctors advise against intercourse during pregnancy?

Dr. Danilenko-Dixon:Your physician may recommend abstinence during the last weeks of pregnancy as a precaution. There is one study which suggests that intercourse more than once a week in the last month of pregnancy may increase the risk of intrauterine infection, but this has not been corroborated by subsequent studies.

If vaginal bleeding, an incompetent cervix (a weakened cervix that dilates prematurely), preterm labor or placenta previa (a placenta that covers the cervical opening) develops at any point in your pregnancy, your health care provider will most likely advise against intercourse. Other conditions of pregnancy, such as expecting twins, also may preclude intercourse during the late second and early third trimesters, when the consequences of preterm birth are greatest.

Your health care provider also may advise against intercourse if you have a history of recurrent miscarriages or premature labor.

We: Is the use of condoms advised?

Dr. Danilenko-Dixon:All women (including those who are pregnant) who have new or multiple sexual partners should use condoms to prevent sexually transmitted diseases (STDs). Pregnant women exposed to STDs are at increased risk of infections that can be harmful to the baby and can lead to premature labor.

We: How may a woman's sexual desire be affected by her pregnancy?

Dr. Danilenko-Dixon: Decreased interest in sex early in your pregnancy may play a significant role in your sexual activity. Changing hormones, added weight and a decrease in your energy level may take their toll on your desire.

The lackluster interest may continue through the first trimester, when exhaustion and nausea are most likely to occur. During the second three months, however, you may find your interest changing. Increased blood flow to your sexual organs and breasts may rekindle your desire, or even increase your normal interest in intercourse. You may even experience a moderate feeling of sustained readiness due to the effects of increased blood flow to your sexual organs and breasts.

As you enter the final trimester, you may find your desire waning again. Besides a large abdomen that makes intercourse physically challenging, increased fatigue or back pain can dampen your enthusiasm for lovemaking. You may need to experiment with positions that make intercourse comfortable for you and your partner.

We: How can couples deal with these changes in sexual desire?

Dr. Danilenko-Dixon: Communicate. Pregnant women may want affection from their partners without wanting intercourse. Partners, however, may read that lack of interest as a sign of rejection. It's important to communicate one's needs, and to discuss other forms of lovemaking, such as oral sex, massage and masturbation.

We: Why is sex during pregnancy so rarely discussed?

Dr. Danilenko-Dixon:The literature on the subject is often confusing, and some physicians are uncomfortable discussing matters of sexuality with patients. For these reasons, couples often get the message that they should refrain from sex during pregnancy. It's still too often a taboo subject — but it shouldn't be.

We: How soon after delivery of a baby may couples resume intercourse?

Dr. Danilenko-Dixon:The answer varies. In general, sexual intercourse can be resumed by the third postpartum week — if comfortable and there are no complicating factors. However, couples often face changes in their sexual relationships as new parents. It's normal, and if you have questions you should ask a trusted health care provider.

Breastfeeding VS Bottle-feeding

2009-09-24T07:36:00.000-07:00

Advantages of Breastfeeding:

Helps your uterus get back into shape
It's the most complete and balanced nutrition for an infant
Gives baby protective antibodies (to protect her from illness)
No artificial ingredients are added
The milk is always warm
Breastmilk is easier for your baby to digest
Baby's diapers smell less offensive (mild smelling bowel movements)
Provides intimate bonding experiences (skin-to-skin contact)
Much Less Expensive (Formula costs about $1000/yr)
Breastfeeding is relaxing for mom
Do not have to recycle as many containers
More convenient - doesn't need to be mixed and bottles don't need to be washed and sterilized
Less chances of allergic reactions in your baby
Keeps you well-endowed (a benefit for your husband)
Many women don't menstruate while breastfeeding
You get to eat an extra 500 calories
Reduces your chances for breast cancer

Advantages of Bottle-feeding:

Some women experience a decreased sex drive when breastfeeding
No need to be discreet when feeding your baby in public*
Other family members can enjoy the feeding/bonding experience*
Dad can help with the midnight feedings*

*These advantages are also available when breastmilk has been pumped.

Choosing The Perfect Baby Name: 12 Rules

2009-09-24T07:25:00.000-07:00

One of the most important things you will ever do for your child is choosing his or her name. Your child's name will be a reflection of character and identity. A well-chosen name will be a source of pride for your child's lifetime. There are several factors to consider when choosing a baby name. The following hints should prove useful for parents who are searching for the perfect name for their baby.

1. Sound: The general sound and rhythm of the name is very important. You will say it and your child will hear it over and over again. Does the name sound pleasing when you say it aloud? How does it sound with your surname and with middle names you are considering? If you have other children, how does the name you are considering sound when said with their names?
2. Uniqueness: It is hard to find the perfect balance between finding a name that is unique and special but doesn't seem too strange. You will have to determine your priorities. There are benefits and disadvantages to both having a common name and a very unique name. Common names are easily spelled and recognized and may cause your child less problems in the schoolyard in early years. Having a unique name, however, may make your child stand out and feel extra special.
3. Popularity: Baby names tend to follow trends and cycles of popularity. Aside from the extremely common names that have always been popular, names that are currently very trendy are likely to go out of style. When choosing a baby name, try to be objective and be sure that this name will sound as good in fifty years as it does today. It might also cause some hardship for your child to find that there are three other children in the same class with the identical name. Some parents look for extremely rare names to avoid the problem of overly popular names, while still others try to find a name that is fairly popular, yet not overly trendy.
4. Associations: Many parents feel that it is very important to find a name that conjures positive or meaningful associations. What do you think of when you hear the name? You may want to choose a name that reminds you of someone or something or a place that is significant to you.
5. Meaning: While you won't think of the meaning of your child's name every day, it may be important to choose a baby name with a positive meaning since it will sometimes be associated with your child. You can also choose meanings that reflect qualities and traits that you hope your child will possess. Or you can choose meanings that are significant to you for any reason.
6. Origin: There are no rules that state that you can choose a name only from your own ethnic origin. Many parents are now finding beautiful and interesting baby names from a wide variety of ethnic and historical origins. You may, however, find that the right name from your own heritage provides an added source of identity for your child.
7. Nicknames: Before you choose the name you adore, think about the possible ways it can be shortened and the nicknames that may result. Do you like the potential nicknames your baby may have? If not, you or your child can always insist on using the formal name. If the name lends itself to a very undesirable nickname, however, you may want to reconsider. Conversely, if the name lends itself to many positive nicknames, this is a definite plus.
8. Spelling and Pronunciation: Many unusual names are difficult to spell or pronounce because people are unfamiliar with them. This does not necessarily mean that you should not choose a unique name that you love on the basis that it could be difficult to spell or pronounce, but when ranking names, it is a factor to consider. Similarly, creative spellings or pronunciations of popular names will have your child constantly correcting those that mistake it with its more popular counterpart.
9. Initials: As you narrow your search, it is also a good idea to be sure that your baby's initials don't spell or represent anything undesirable.
10. Gender Identification: Some people think it is very important that a name has a clear gender identification, while others find it less important. Many names are ambiguous. If you decide that it is important that your child have a name with a clear gender identification, you will probably want to rule out those names that are being used for both boys and girls.
11. Family and Friends: Once you have found what you believe is the perfect baby name, you may be anxious to discuss it with your friends and relatives. You can expect to get mixed reviews. Some people like to get feedback from others, but bear in mind that there will always be someone who opposes your choice and this can make finding a name very frustrating. You may even want to resist announcing your choices until after your baby is born to avoid that situation.
12. A Final Note: In your search for the perfect baby name, you'll find that very few names meet all the criteria suggested here. But once you decide on your priorities for a name, it should be easy to find several that meet most of them. While these suggestions should provide rational guidance, choosing a name is very emotional. The most important thing is that you love the name. Good luck on choosing the right name and best wishes for your joyous moments ahead!

Bottlefeeding Basics

2009-09-23T02:50:00.000-07:00

It's OK not to nurse. While most experts now agree a mother's natural milk is more nutritious than formula, there are many valid reasons why parents may choose to bottlefeed instead.

Premature babies are often born with a weak sucking reflex, and lack the strength to nurse. Some mothers are separated from their baby shortly after birth, while others must take medication that can be passed through breast milk. And in today's world, many moms must return to the workplace and are not available whenever the child is hungry. In such cases, formula offers an alternative that is both nutritious and convenient.

Powdered, Concentrate, or Ready-to-Feed

Today's formulas are all pretty similar, but they come in several different varieties. Ready-to-feed is definitely the easiest to use, but also the most expensive. It comes in small cans because they only last about a day in the refrigerator after opening. Powdered is cheaper, but a bit more cumbersome to prepare. It also has a fairly long shelf-life. Concentrated formula is diluted with water before serving. Many parents use more than one type, packing convenient single-serving cans of ready-to-feed for days out, while keeping a container of inexpensive powder at home.

Supplementing Breastfeeding with a Bottle

Many parents opt to supplement breastfeeding with an occasional bottle. This allows Dad to sometimes take over feeding duties, which can be a welcome relief to exhausted moms in the middle of the night. This also gives new fathers some valuable one-on-one time with their babies. However, it's a good idea to wait until the baby is at least three to four weeks old before introducing a bottle. Artificial nipples are much easier to suckle than human ones, and infants need time to learn how to nurse from a breast. Switch to a bottle too soon, and the baby may get used to the faster flow and be reluctant to go back to the mother's bosom. Don't wait too long to try a bottle, or the baby may refuse to try anything other than the real deal.

Bottlefeeding 101

Preparing a bottle isn't difficult, but there are a few things to remember. Most metropolitan water supplies are perfectly safe for babies, so there's no need to boil water before mixing it with formula powder or concentrate. Remember to sterilize all bottles and nipples before they are used for the first time, but a thorough cleaning in soapy water will be fine after that.

Although there's nothing wrong with serving formula cold or at room-temperature, many babies prefer warm formula, especially if they are already used to body-temperature breast milk. Bottles should be heated in a pan of warm water or under a hot tap. Never use a microwave because they often heat unevenly, and hot milk can burn a child. Test the temperature by dribbling a few drops on your forearm -- if that feels too hot for you, it's too hot for baby.

Most pediatricians recommend feeding babies on demand, and using a bottle makes it much easier to keep track of how much they are actually eating. Make sure to tip the bottle so there's formula coming out, not air.

Breastfeeding Basics

2009-09-23T02:48:00.001-07:00

You may have heard the message before "- breast is best -" but in this case, it's not all hype. The American Academy of Pediatrics (AAP) recommends breastfeeding at least for your child's first year, and longer if possible. Breast milk, according to the AAP, is "uniquely superior for infant feeding." It has many nutrients that shore up your baby's immune system to they can fight off diseases, and adjusts to your child's nutritional needs as he grows older.

Studies show that breastfeeding decreases your baby's risk of developing diarrhea, lower respiratory infection, ear infections, bacterial meningitis, urinary tract infection, and many other illnesses. Research also suggests that breastfeeding may make your baby less prone to SIDS, Crohn's disease, and other serious conditions. Plus, nursing allows a mother and her baby to bond; many nursing mothers say they enjoy the skin-to-skin contact breastfeeding allows, and the kids seem to like it, too.

Breastfeeding benefits the mother as well. According to La Leche League International, it can help a new mom lose weight more easily because she burns calories while she nurses. Also, the act of breastfeeding triggers the release of a hormone called oxytocin in the mother's body, which helps her uterus return to its normal pre-pregnancy size. Nursing also helps the body produce prolactin, a hormone that brings on a relaxed state of being.

What You Need To Know

Some moms and babies take to breastfeeding easily, while others have to learn how. The process doesn't always go smoothly. With this in mind, prepare to invest a few weeks to learn how to breastfeed well. It's important that your baby latches on properly so both of you are comfortable during feedings. You may want to consult a certified lactation consultant to learn the basic techniques. You can find one at the hospital where you gave birth, or ask your physician for a referral.

If you suffer from sore, cracked, or bleeding nipples, or experience other problems, a lactation consultant or your physician can recommend a course of treatment. Often, these problems resolve themselves as you get better at breastfeeding. If you feel engorged (as if your breasts are too full), you may need to nurse more often or use a breast pump in between feedings. But if you get a fever, experience flu-like symptoms, or have any other concerns, call your doctor immediately. You may be suffering from mastitis, a breast infection that will need antibiotic treatment.

How Often You Should Nurse

Most medical experts recommend nursing on demand. That means your child sets the schedule for you. If he seems to get hungry every two hours, feed him accordingly. If he seems to need to nurse more or less often, follow his lead. Learn your baby's cues. Does he cry out for food in a certain way? When you hold him, does he root around in search of your breasts? He may be signaling a need to nurse. Try not to worry about whether your baby is getting enough milk. As long as he's growing and gaining weight steadily his pediatrician should be able to tell you during his doctor's visits, and if he appears healthy, happy, and alert, you're doing fine.

Sleep Patterns & Changes

2009-09-23T02:48:00.000-07:00

Every exhausted parent dreams of a child that sleeps soundly all through the night. But in fact, sleeping that long is not normal until babies reach about three to four months of age. Adjusting to an infant's sleeping habits is one of the most difficult aspects of bringing a new member into the household, and is certainly one of the first that new parents have to grapple with.

"Kids cry. They cry around the clock, when they are awake and when they are asleep and when you are asleep," warns Brett Kuhn, an associate professor of pediatrics at the University of Nebraska Medical Center who specializes in behavioral pediatrics. "That's just their way of communicating with us. It's a fact of life."

According to Kuhn, infants sleep some 16 to 17 hours per day, which drops to about 14 hours by the time they reach their first birthday. A more significant change is when they sleep, as they also learn to consolidate sleeping into longer chunks during the night. But that doesn't happen for several months. "A newborn will wake up every two to four hours, regularly," he said. "Their stomachs will wake them up because they are hungry. Infants have a huge need for caloric intake at that age."

As babies become better at consuming larger meals, they can go longer between feedings. That's when it becomes the parents job to teach kids when to sleep, and how to sleep.

One of the first tasks is to make a clear distinction between night and day. Babies will notice that sometimes it's dark and sometimes the house is bright. Parents should reinforce this by dimming the lights at night, putting toys away, shifting to less energetic activities and in general showing that nighttime is when people wind down to rest.

Children must also be taught how to fall asleep - it's not an innate skill. Kuhn recommends that babies be placed in their crib or bassinet while drowsy, but still awake. "If the only way children ever learn how to fall asleep is if their parents feed them, rock them or cuddle with them until they are fast asleep, that's the only way the will ever know how to sleep," he said. "When they wake up in the middle of the night, they will expect the same pattern of behavior to go back to sleep and they will cry until they get it."

While kids start off with a 24-hour sleep and nap pattern, they soon shift to longer sleeping cycles at night, punctuated with brief feeding breaks. At four to six months, most kids are taking about three naps during the daytime, lasting from one to two hours. By their first birthday, most will cut back to two naps, ranging from about 90 minutes to two hours. Shifting to one nap per day can happen anywhere from 18 months to two years, and the final nap may remain until the child is five years old.

Some parents try to keep babies awake longer during the day or force them to skip naps, hoping the child will become especially tired and fall asleep easily. Kuhn said the exact opposite will happen. "That's a common mistake, but what you really end up with is a cranky, sleep-deprived child that is wired on stress hormones and will be even harder to put to sleep," he said. "As a general rule of thumb, good sleep during the daytime will produce good sleep at night."

Coping Strategies for Tired Parents

2009-09-23T02:40:00.000-07:00

Kids can be a lot of fun, but they also require a lot of work. Especially babies. Having an infant in the house can be overwhelming, and most new parents struggle with the increased demands on their time. Besides learning to change diapers and trying to remember the words to old lullabies, one of the most important skills parents must develop is time-management. Adjusting to a new baby takes much more than just making a list of things to do -- it's a complete change in lifestyle. Don't believe it? When was the last time you were awake at 4 a.m., dancing along to the Barney Bop? Coping with sleep deprivation is a common challenge for new parents, but there are several strategies to help families adjust to their plus-one status.

Bed, Bassinet, or Crib?

One of the first decisions for new parents is where their child will sleep -- and how far they are willing to walk when the child wakes up at night. Some parents make sure Junior sleeps in his own crib, and in his own room. This will instill a sense of personal space, and teach kids that they have their own room for sleeping. However, for this lesson to really sink in, parents must be diligent about putting the child back into his crib after every midnight feeding. An easier approach is to place a bassinet close to the parents' bed. This allows for easier retrieval when the baby stirs at night, and Mom and Dad will eventually become more attuned to the gentle whimpers and sighs that precede waking. With practice, they may be able to feed or change a sleeping baby and everybody can go right back to sleep. Some families choose to bring the kid into the big bed. If the mother is breastfeeding, she can continue to sleep while the baby nurses himself right back to sleep. Babies also enjoy the family coziness, and it's a good opportunity for dads to snuggle, too.

The Third Shift

Babies will always wake up in the middle of the night. It's a fact of life, so get used to it. No matter where the child sleeps, there will be times when he won't go back to dreamland without an extensive ritual that could include anything from gentle rocking to vigorous dancing, total silence or 700 repetitions of the same lullaby. Sleep deprivation is a part of parenting, and it requires cooperation to make sure both partners are getting enough rest. While couples may initially try to solve this problem together, it really only takes one person to comfort the child, so trade off duties at night. If one person is working, recognize that this will likely require functioning at a fixed time in the morning. But that doesn't mean that the other parent is lolling in bed all day, because caring for the unpredictable demands of an infant is extremely demanding. So, make sure you get enough rest the night before a big meeting, but be willing to take over the role of prime parent as soon as you get home. Flexibility and teamwork is the key to making this work.

Build Good Sleep Habits

Simple rule: if the baby is sleeping, you can sleep too. So start teaching good sleep habits from the start. After nine months in the dark, kids don't initially understand the difference between night and day, between play time and rest time. It's important to create a consistent schedule, so the child learns that it's time to settle down once the sun goes away. Try to dim the lights, turn down the music and begin the bedtime ritual at about the same time every evening. Babies like routines, and can quickly realize that bath time is always followed by a feeding, a picture book and finally bedtime. Once the child starts to learn how to sleep, the parents can start to reclaim some of their own personal time at night.

Get Professional Help

It was hard enough to keep the house clean before the baby was born; now that she's arrived it's just about impossible. So stop stressing about not being able to accomplish the impossible. It's important to recognize that energy is a finite resource, and if it's all directed at caring for the child, there isn't much left to use dusting the top of the refrigerator. So don't worry if the dishes stay in the sink for three days, or if the laundry is piling up, or if the bed hasn't been made in more than a week. This is a great time to sign up with a cleaning service, and start collecting menus from local restaurants that deliver. If friends and relatives offer to help, ask them to bring over a meal and insist on keeping the leftovers for the next day's lunch. There's a whole lifetime to do chores, but there's only a few brief months to watch the baby spit up formula.

Mechanical Aids

There's nothing wrong with using mechanical help to induce sleep. Rhythmic motion is extremely relaxing for babies. You can relax and read in bed while gently pushing a cradle back and forth with your foot. No home is complete without a baby swing, with either a battery-powered or wind-up motor to keep the seat moving. The back-and-forth motion is almost certain to bring on drowsiness or sleep, but since parents should never leave kids unattended in a swing, it's better for nap time than bedtime. And on those occasional nights when she just won't go back to sleep, a midnight drive is certain to do the trick. You'd be surprised how many other beleaguered parents you'll see heading for the all-night convenience store.

The best way to survive this difficult, but temporary, period is to follow the baby's cues. Sleep when the baby sleeps, cry when the baby cries. And don't forget to laugh when the baby laughs.

Not Designed to Sleep Alone

2009-09-22T01:56:00.000-07:00

by Dr. Jay Gordon

The official position jointly proposed by the CSPC and the crib manufacturers' lobbyists will cost many babies their lives. Here's why:

Babies sleeping on a safe surface with sober, nonsmoking parents respond to their parents, and the parents respond to them. The chance of SIDS occurring in this situation is as close to zero as we can measure. For better or worse, most babies have never sneezed in their parents' beds without their parents knowing it. How could they possibly stop breathing without our immediately being aware of the problem and quickly stimulating them back to a regular, safe respiratory pattern?

Babies in a crib or in a room away from their parents will breastfeed less and are at greater risk of infections, including life-threatening ones. We have politely begun calling crib death "SIDS" (Sudden Infant Death Syndrome) to remove the stigma many parents have felt about their use of cribs. If there were a disease or cause of infant fatality called "chair death," we would certainly think twice before placing our children in chairs in a separate room for eight or ten hours.

The medical profession, as it often does, is approaching the entire idea of the family bed backward. A baby in the same bed with his or her parents is surrounded by the best possible surveillance and safety system. It must be the responsibility of the manufacturers and proponents of cribs and separated sleep to prove that such disruption is safe, not the other way around. The combined wisdom and experience of governmental "experts" is dwarfed by that of James McKenna, Director of the University of Notre Dame's Mother-Baby Sleep Laboratory. His research and writing explain very clearly that no sleeping situation is 100 percent safe, but that many more babies have suffocated in cribs than in beds shared with their parents.

In 23 years of pediatric experience, I have never had a case of SIDS in my practice. I might be a pretty good doctor, but I'm not that good. Vitally, all of the families I have cared for sleep in the same bed with their babies for either the entire night or the major part of it. These families succeed at breastfeeding and succeed at raising babies and children with fewer episodes of ear infection, pneumonia, and other illnesses than they would be expected to have, according to medical texts.

Newborn babies breathe in irregular rhythms and even stop breathing for a few seconds at a time. To put it simply, they are not designed to sleep alone.

When Your Baby Prefers One Breast to the Other

2009-09-22T01:49:00.000-07:00

It is not uncommon for a young baby to develop a preference for one breast or the other. Our son developed a definite preference, early on, for the left breast. There were times, during the first few weeks, when I couldn't get him to nurse at all on my right side, even though he would latch on and nurse like a trooper on the left.

Then one day, just for the heck of it, I tried the football hold (baby's body under your arm, like a person carrying a football, his head cradled in your hand, and latched on that way, his torso alongside yours (under your arm), and his legs and feet sticking out behind you), along my right side. It worked like a charm! For several weeks we would nurse that way...latching him on to the left via a traditional cradle hold, but using the football hold for the right breast.

When he got a bit bigger, I figured out that I could cradle hold him as if I was going to put him to the left breast, but twist my upper body around enough to actually give him the right breast.

Also, and this really helped, I figured out that if I was nursing him while we were laying down, I could lay on my left side, and feed him "normally" (from the left breast) or angle myself over him a bit and give him the right breast, which he would take with no problem from that position.

Eventually he started accepting the right breast in a traditional cradle hold, but to this day, if he's tired, or upset, or anything, really, only the left breast will do the trick.

So, in summary, if your baby expresses a strong preference for one breast over the other:

Try holding baby in the football hold when trying to get them to nurse from the disfavoured breast.
Try laying down with baby, you on the side your baby prefers (i.e. if baby prefers your left breast, lay on your left side, with baby facing you, vice versa for the right), and offer baby the disfavoured breast from that position, by twisting over baby a bit.
If you can comfortably do so, try holding baby in a cradle hold as if you were going to offer them the breast they prefer, but then twist around at the waist, and instead offer them the other breast (this is a bit easier for women who are larger chested and, shall we say, not quite so gravity-defying in that area).
And last, but not least, hang in there! This too shall pass!

The Bedtime Debate: Cry or Comfort?

2009-09-22T01:37:00.000-07:00

A baby's early sleep patterns are at the heart of one of the biggest controversies in modern parenting: how to teach kids to fall asleep. One theory suggests that kids should be gently but firmly put into their crib at bedtime, and no matter how much they whine or cry, should not be allowed to get out until morning. Advocates suggest this teaches kids that nighttime is for sleeping, and that they will quickly adapt to the situation by learning to fall sleep on their own.

An opposing view holds that such rigid discipline at an early age will only teach children that mommy and daddy can't be depended upon for comfort. Instead, parents should offer all the love and snuggles that baby wants, and this in turn will help kids feel safe and secure enough to easily relax and fall asleep.

One of the main voices in the "crying-it-out" camp is Dr. Richard Ferber, whose book on the subject, Solve Your Child's Sleep Problems, is one of the prime resources for parents who opt to follow this route. In fact, his name has become a synonym for the technique, and parents who use his method to teach sleep habits often say they are practicing "Ferberization."

He recommends putting babies into their crib and letting them know it's bedtime. If the baby cries, do not respond at all for a few minutes, but then go into the room to reassure the child that her parents are in the house and they really do love her. It is important at this point to not pick up the child. This will reinforce that it really is bedtime. Each time the baby cries, wait a bit longer to respond. Within a few nights of practicing this technique, parents may be allowing her to cry for up to 15 or 20 minutes before going back into the nursery. Ferber says most children will learn in just a few days that crying doesn't result in being taken out of the crib, and instead will learn to quickly fall asleep on their own.

"This is one of the best ways to teach kids how to fall asleep on their own," said Brett Kuhn, an associate professor of pediatrics at the University of Nebraska Medical Center who specializes in behavioral pediatrics. "However, the downside is that parents have to listen to their children crying, and that can be very difficult."

It's true that the Ferber method is usually effective. However, some experts such as Dr. William Sears discourage this approach because it may teach the child that her parents are not offering unconditional love, a potentially damaging realization to a young psyche. Critics say Ferberized babies stop crying not when they realize it's easier to go to sleep, but when they abandon hope of receiving the desired comfort and love from their parents.

Instead of letting baby cry, alternative approaches focus on making the baby feel secure and loved. This could involve some personal hug time, or frequent visits to the crib just to show the little one that her parents are available and responsive to her needs.

In the end, both methods work and there is no consensus among experts about which one is best. Parents should adopt a sleep-training program that meshes with their own view of parenting, and their own willingness to be available at night. "This is usually the first behavioral issue that requires parents to figure out how to define their parenting philosophy," noted Kuhn. And solving this issue is one of the first major milestones on the long parenting road.

Find Out the Truth....

2009-08-24T15:20:00.000-07:00

And the Answers Are...

That there are no "right" answers! All of the possibilities and personalities described in the quiz can go into the making of a great parent (okay, so maybe anyone who selected 2d, 3e, or 8b is in need of a good long talk with a trusted mentor). No one is ever perfectly "ready."

No matter who you are, you can count on parenting bringing lots of surprises, challenges, and incredible gifts into your life.

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2009-07-04T13:27:00.000-07:00

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