What Do I Do When My Bag of Waters Break?

It is common to be in labor without your water breaking.  Actually, only thirty percent of women experience their water breaking before the start of labor.

What Is My Bag of Waters?   The bag of waters—or amniotic sac—is a bag or “membrane filled with fluid that surrounds your baby in your uterus during pregnancy.”  The bag of waters is very important to your baby’s health.  The fluid protects your baby and gives your baby room to move around.  The bag itself protects your baby from infections that may get into your vagina.

  Is it urine or is it amniotic fluid? If you are leaking, it can be difficult to determine if your membranes are leaking or if it is urine.  In most cases, it is probably urine.  There are several ways to tell the difference, but there is no definite answer.  When in doubt, smell it! Urine has a distinct smell and color.  You will leak urine when your bladder is full, when coughing , sneezing or laughing; even when you are exercising.  

Only 3 percent of pregnant women will go into premature labor (before 37 weeks) as a result of ruptured membranes.   In most cases your membranes will rupture as you are nearing the end of your pregnancy, and this is definitely one of the early signs of labor.  If your water does break in public, and you have visions of a huge gush of water running all over the floor, then you have probably been watching too many movies.  It is most likely going to occur as a slow trickle, or at most, a small gush of fluid of colorless and odorless amniotic fluid. 

It is common to be in labor without your water breaking.  Actually, only thirty percent of women experience their water breaking before the start of labor.

What Should You Do When Your Water Breaks ?  First, don’t panic!  Follow the instructions your healthcare provider discussed with you if and when your water breaks.  Immediately after your water breaks, know that nothing should be placed in your vagina at this point.  This will help prevent infection.

  •  Wear a maxi pads, not tampons, to keep the amniotic fluid from wetting your clothes
  • Keep your vaginal area clean
  •  When you go to the bathroom,  be sure to wipe from front to back
  •  Sexual intercourse is officially off-limits  

Call your healthcare Provider immediately if:  

  • Your due date is more than 3 weeks away from today
  •  The water is green, or yellow, or brown, or has a bad smell
  •   You have a history of genital herpes, whether or not you have any herpes sores right now
  •  You have a history of Group B strep infection (“GBS positive”)
  •  You don’t know if you have GBS or not
  •  Your baby is not in the head-down position, or you’ve been told it is very high in your pelvis
  •  You have had a very quick labor in the past, or feel rectal pressure now
  •  You are worried.
  •  If you feel something in your vagina, or see any of the umbilical cord at the vaginal opening, get medical help immediately  

Call your health care provider within a few hours if:

 •Your due date is within the next 3 weeks and

 • You are not in labor and the fluid is clear, pink, or has white flecks in it

 • Your baby is in the head-down position

 •Some health care providers will want you to come in to the office to confirm that the bag of waters has broken and listen to the baby’s heartbeat as soon as you notice that the bag of waters has broken.  Others will suggest you stay home for several hours to wait for labor to start.  

What Do I Do Until Labor Starts?   Most women will go into labor within 48 hours.  If you are waiting for labor to start and your bag of waters has broken:  

• Put on a clean pad  

•Do not put anything in your vagina

 •Drink plenty of liquids—a cup of water or juice each hour you are awake

 •Get some rest

 •Take a shower

 •If there is any change in your baby’s movements, call your health care provider right away  

Check your temperature with a thermometer every 4 hours—call right away if your temperature goes above 99.6.   For more information regarding this topic visit:

  www.acnm.org  

www.webmd.com

 

Benefits of Daily Probiotics

Probiotics are beneficial bacteria that help maintain the natural balance of organisms (microflora) in the intestines between harmful and beneficial bacteria and work to remove toxins from the body. The normal human digestive tract contains about 400 types of probiotic bacteria that reduce the growth of harmful bacteria and promote a healthy digestive system. The largest group of probiotic bacteria in the intestine is lactic acid bacteria, of which Lactobacillus acidophilus, found in yogurt with live cultures, is the best known. Yeast is also a probiotic substance.

Probiotics promote healthy digestion by providing beneficial bacteria to recolonize and balance the GI tract, and hinder the growth of harmful, toxic bacteria, while also promoting a healthy immune system.

Probiotics may seem new to the food and supplement industry, but they have been with us from our first breath. During a vaginal birth while the newborn passes through the birth canal, a newborn picks up bacteria from his/her mother. These good bacteria are not transmitted when a Cesarean section is performed and have been shown to be the reason why some infants born by Cesarean section have allergies, less than optimal immune systems, and lower levels of gut microflora.

What are probiotics used for?
Some people use probiotics to prevent diarrhea, gas, and cramping caused by antibiotics. Antibiotics kill “good” (beneficial) bacteria along with the bacteria that cause illness. A decrease in beneficial bacteria may lead to digestive problems. Taking probiotics may help replace the lost beneficial bacteria. This can help prevent diarrhea.

A decrease in beneficial bacteria may also lead to other infections, such as vaginal yeast and urinary tract infections, and symptoms such as diarrhea from intestinal illnesses.

Probiotics may also be used to:

• Help with other causes of diarrhea.

• Help prevent infections in the digestive tract.

• Help control immune response (inflammation), as in inflammatory bowel disease (IBD).

Poor food choices, emotional stress, lack of sleep, antibiotic overuse, other drugs, and environmental influences can all shift the balance in favor of the bad bacteria.

When using probiotics, the idea is not to kill off all of the bad bacteria. Our body does have a need for the bad ones and the good ones. The problem is when the balance is shifted to have more bad than good. An imbalance has been associated with diarrhea, urinary tract infections, muscle pain, and fatigue.

Maintaining the correct balance between the “good” bacteria and the “bad” bacteria is necessary for optimal health.

When the digestive tract is healthy, it filters out and eliminates things that can damage it, such as harmful bacteria, toxins, chemicals, and other waste products. On the flip side, it takes in the things that our body needs (nutrients from food and water) and absorbs and helps deliver them to the cells where they are needed.

The other way that probiotics help is the impact that they have on our immune system. Some believe that this role is the most important. Our immune system is our protection against germs. When it doesn’t function properly, we can suffer from allergic reactions, autoimmune disorders (for example, ulcerative colitis, Crohn’s disease, and rheumatoid arthritis), and infections (for example, infectious diarrhea, Helicobacter pylori, skin infections, and vaginal infections). By maintaining the correct balance from birth, the hope would be to prevent these ailments. Our immune system can benefit anytime that balanced is restored, so it’s never too late.

Probiotics convert the fiber in food into healthy fatty acids that nourish the cells that line the intestines. They also help the intestines make short-chain fatty acids, which contribute to the overall health of the body.

Benefits of Probiotics in Pregnancy
Many women suffer from digestive issues, such as heartburn, diarrhea, constipation and intestinal cramps, during pregnancy. Probiotics help relieve constipation and other intestinal issues by improving gastrointestinal function. The healthy bacteria can also improve the immune system of both the mother and baby during pregnancy. Probiotics can help you fight off or avoid colds and other illnesses, which is essential during pregnancy due to a suppressed immune system. Taking probiotics during pregnancy may also help prevent allergies and eczema in both mothers and infants.

A study performed by the Norwegian University of Science and Technology discovered a lasting impact on babies whose mothers took probiotics during pregnancy. According to this study, babies and toddlers up to 2 years old were 40 percent less likely to suffer from eczema compared to babies whose mothers did not drink probiotics. Additionally, babies who did experience eczema had less severe cases. This study, which was published in the “British Journal of Dermatology,” highlights the effectiveness in preventing eczema in children and did not indicate any adverse risks to the mother or baby.

References
Parenting; Ask Dr Sears: Probiotics During Pregnancy?; William Sears;
http://alturl.com/354h8
Pregnancy Today; Probiotics and Pregnancy; Teri Brown
Colorado State University Extension; Food Safety During Pregnancy; J. Dean & P. Kendall; December 2006
San Mateo Medical Center; Acidophilus and Other Probiotics; 2011

Originally posted on WomanPlace - Health & Nutrition:

Red Raspberry leaf tea is one of the safest and commonly used tonic herbs for women wanting to get pregnant or for women who are already pregnant. Red Raspberry Leaf (Rubus idaeus) tones the uterus, improves contractions and decreases constipation. Most tonics need to be used regularly, for a tonic is to the cells much like exercise is to the muscles; not much help when done irregularly . But you will still benefit even from occasional use of tonics during pregnancy, since they contain nourishing factors. The herb comes in forms of leaves to make teas or tonics as well as pill like capsules you can swallow.
Most of the benefits given to regular use of Raspberry lea tea throughout pregnancy can be traced to the strengthening power of fragrine, an alkaloid which gives tone to the muscles of the pelvic region, including the uterus itself; and to the nourishing…

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Peace of Mind & Living Free of Fear of Losing a Child

 

Your family is your life and protecting your children from harm’s way is a growing problem and now it is now possible with technology.  Your child’s safety and whereabouts can now be monitored via your smartphone.  Children can have the ability to alert you when they are under duress, in trouble or find themselves lost.

Children 2-10 years old, toddlers and even newborns traveling and under supervision of others can be monitored 24/7 in five minute intervals and located immediately and automatically via e-mail or text messaging.  You set the schedule – minutes or hours – and receive regular alerts with the exact location of your child.  An SOS button allows older children to summon for help which includes their location as well as automatic tracking alerts to entrusted individuals you choose to receive them.

This child tracking solution is dependent upon 2 technologies – GPS (Global Positioning System) and wireless communications or cell phone (GSM). Anywhere you can receive both a GPS signal and have cell phone reception, the solution will work.

The solution was developed by the father of a young daughter who became lost at an amusement park for several hours.  After finding her and being an IT technologist, decided to develop a solution for preventing this from happening again.   He funded Amber Alert GPS and engineered the Law Enforcement Alerting Portal (‘LEAP”) used by law enforcement in states to issue the actual Amber Alerts.  The LEAP system is the fastest and most efficient alerting technology in the nation, and allows States to share Amber Alerts cross-borders. To date, law enforcement in the States using the LEAP system have a 100% recovery rate of all children for whom an Amber Alert was issued.

Protect your children.

Choosing Your Pediatrician for Your Baby

presented by Angel J. Miller, MSN, CNM

The following is an excerpt of a chapter from the book Raising Your Child in Washington, DC, a resource for parents available in local bookstores.   by Dr. Michele R. Berman

One of the most important tasks a parent must undertake is the selection of a pediatrician for their baby or older child.  Besides being a place to take a sick child, or a place to get “baby shots,” a pediatrician’s office is an important resource for new or experienced parents.  Today, many families find themselves without the traditional support systems that their own parents had available to them.  Family members are often separated by many miles.  For these families, the pediatrician provides advice and encouragement, as well as basic child-care knowledge.  Many pediatricians see patients from birth through adolescence, so picking the right pediatrician may well be the beginning of a “long term relationship.”

Pediatrics, in general, is a preventive health care specialty.  Well-care visits provide the framework of information to keep your child happy and healthy.  A typical well-care visit starts with weighing and measuring the child and plotting those measurements on a growth chart to follow their progress.  The pediatrician will then ask several questions about your child’s eating, sleeping, and bowel habits, and about what new developmental milestones have been passed.  Then it’s your turn to ask the doctor about any questions or concerns you may have.   Write them down as you think of them at home, and bring the list with you.  After examining the child, the pediatrician may discuss a variety of topics, such as immunizations, safety issues, or behavior issues.  Some will also have handouts to supplement the discussion.  On average, there are seven well visits in the first year, three in the second year, and one every one to two years thereafter.

The Prenatal Appointment

If this is your first child, the decision as to who the baby’s pediatrician will be should be made well in advance of your due date.  (Remember – babies often come earlier than expected!)  This allows the pediatrician you choose to give your newborn its very first exam in the hospital, and to support you during those joyful, yet overwhelming first days.  Although all pediatricians are dedicated to helping you raise healthy, happy children, each has his or her own approach.  You will, therefore, want to meet with several pediatricians so that you can pick the one with whom you feel most comfortable and whose approach is most consistent with your own ideas about child raising.

Most pediatricians encourage parents to come for a prenatal appointment.  This is your opportunity not only to meet the pediatrician but look at the office itself.  If possible, both parents should be present, so you will both agree on your choice.  When you set up the visit, find out who you will be seeing (one or more doctors? Office staff?), about how long it will last, and if there is a charge for the visit.  If the visit consists of a quick hello by the pediatrician while the office staff shows you around, there may not be a fee.  However, there may be a charge if the pediatrician sets aside a block of time specifically to talk with you and answer any questions you have.  Many insurance companies will pay for this, but check with your plan first.

During the interview you should first find out about how the practice works.  What are the office hours?  Do they include evening or weekend hours?  How are after-hours calls handled?  Who are the doctors in the practice and what are their qualifications?  Can you see any of the doctors in the group, or are you assigned to one doctor?  How far in advance do you have to call to get a well child appointment?  A sick child appointment?  To what hospitals do the doctors admit their patients?  Do the doctors come to the hospital where you are delivering?  Who handles phone calls during the day and after hours?  What is the schedule of visits and immunizations?  Most pediatricians follow the guidelines of the American Academy of Pediatrics for these.

Secondly, try to get a feel for the pediatrician’s personality.  How does he/she respond to your questions?  Does he/she seem open to your concerns or does he/she seem to shrug them off?  Are they stiff or relaxed?  Distracted?  Do they have a good sense of humor?  Observe how he/she interacts with the patients that may be in the office at the time of your visit.  The feelings you get during your visit will set the time for the relationship you will develop with the pediatrician you choose.  You want to feel comfortable and confident about someone who is going to help you take care of that special baby of yours.

Ask the pediatrician questions about topics such as: What is their thoughts about circumcision, breast feeding, or the use of antibiotics or other medications?  If you are going to breastfeed, what kind of support can they give you?  What is their philosophy about the role of a pediatrician?

Lastly, look around the office.  Does it seem inviting to children?  Are there things for the children to do if they have to wait to see the doctor?  Will older children and adolescents also feel comfortable here?  Are there ways to separate sick from well children?  What kind of feelings do you get about the office staff?  The nursing staff and front desk personnel are also important in making a trip to the doctor a pleasant experience.

Looking for Dr. Right

So, where do you find your dream pediatrician?  There are several ways.  First, ask your friends and neighbors who they use.  Are they happy there?  What do they like about the office?  Is there anything they don’t like?  Next, ask your nurse-midwife for a list of pediatricians they frequently recommend and on whom they have gotten positive feedback.  Your internist, family practitioner and other medical professionals can also be good resources.

Increasingly, families find themselves as part of health plans that limit their choices to physicians who are members of the plan.  In this instance, start with the list provided by the health plan and see which physicians are available in your area.  Then ask the resources listed above what they know about those physicians.  Make an appointment with the pediatricians you’d like to know more about.

Pediatrician’s fees may vary widely.  Don’t be afraid to ask about fees before you go to the office.  Ask if you will have to pay for services at the time of the visit, or whether they will bill you or submit the insurance claim for you.  If you are a member of a health plan, and the pediatrician is a provider for that plan, they will file for you, but you must usually pay a small co-payment at each visit.  Look at your health plan or insurance coverage carefully.  Not all insurance plans cover well-child care, or you may have to meet a deductible, or they may only cover a certain number of well visits.  For these financial matters, it’s best to know what the office policies are before you get there.  If you anticipate a problem with payments, many offices will work with you, as long as you talk to them up front.

As mentioned earlier, many families find themselves using the same pediatrician for many years, so you want to choose one with whom you feel comfortable, and in whom you have confidence.  Shop around.  Ask questions.  Use and trust your instincts.  Remember, your decision does not have to be a final one.  If you are unhappy with your choice, there are many other fine physicians in the area.  Good luck, and happy parenting!

Dr.Berman practiced pediatrics in the Washington, D.C. area until the year 2000 She currently is co-founder with her husband of www.celebritydiagnosis.com.

What is Thrush?

Thrush/nipple yeast and vaginal yeast are caused by the one-celled organism, Candida albicans. It is a fungus that thrives in moist, dark environments (like the nipples, milk ducts, mother’s vagina, baby‘s mouth and/or baby’s diaper area). The use of antibiotics by mom or baby is a contributing factor in the occurrence of yeast. A cracked or sore nipple can also contribute to yeast occurrence.

Here are a few questions to help you determine if you or your baby has a yeast overgrowth. A consultation with your health care provider is also important. If you answer yes to one or more of these, you may have thrush.

  • Have you noticed white spots in your baby’s mouth?
  • Does your baby have a bright red, pimply diaper rash?
  • Is your baby gassy, fussy or not nursing well due to oral thrush?
  • Is the area around your nipple pink, red, itchy, flaky or shiny?
  • Do you feel a burning sensation on your nipples either during or between feedings?
  • Do you have a cracked nipple that won’t heal? 
  • Do you feel shooting pains in your breast (different from the sensation of let-down)? Some women describe the feeling as “a piece of glass” or “stabbing”.
  • Have you or your baby completed a recent course of antibiotic treatment?
  • Did you have a cesarean birth or were you diagnosed with a vaginal Strep-B infection?

**Note: It is rare for a mom to have a red rash or white spots on her nipples with a nipple yeast infection.**
Here are some common treatment for thrush:

It is very important that both mom and baby are treated at the same time, even if only one of them show signs of yeast. Yeast/thrush is highly contagious, and if not treated together, they will keep passing it back and forth to each other. Be sure to continue treatment for at least 2 WEEKS after the signs of thrush/yeast have gone away.

Your health care provider can prescribe a prescription of Nystatin for you and baby -a cream for mom to use on her nipples and oral liquid for baby. Make a run to the store for yogurt containing live, active cultures (especially l. acidophilus). The yogurt cultures (acidophilus) will help get rid of the yeast. If your baby is old enough, you can offer him some, too.

Acidophilus supplements. This does the same thing as the yogurt. You should be able to find acidophilus in the health food section of your grocery store/pharmacy or at a natural foods store. This can also be crushed (or, if you have the caplets, opened) and sprinkled directly on your nipples. If you wish, you can do this just prior to feeding so your baby gets a dose of acidophilus, too.

Gentian Violet. You should be able to find this in your local health food/natural foods store or in the natural food or vitamin section of your store. Using a clean cotton swab, rub some on each nipple. In order to treat baby, also, it works best to put some on your nipple and then latch baby on to nurse. It will coat baby’s mouth while he is nursing. It is a bit messy, so you’ll want to make sure you are wearing clothes you won’t mind get-ting purple stains on. This should only be used for 3 days.

Grapefruit Seed Extract. (not grape seed extract, ACTIVE INGREDIENT MUST BE “CITRICIDAL”), 250 mg (usually 2 tablets) three or four times a day orally (taken by the mother), seems to work well in many cases. If preferred the liquid extract can be taken orally, 5 drops in water three times per day (though this is not as effective). Oral GSE can be used before trying fluconazole, instead of fluconazole or in addition to fluconazole in resistant cases.

Dr. Newman’s All Purpose Nipple Ointment (from his Candida protocol handout): Mupirocin 2% ointment (15 grams), Betamethasone 0.1% ointment (15 grams), and miconazole powder so that the final concentration is 2% miconazole. This combination gives a total volume of just more than 30 grams. This cream requires a prescription.

The combination is applied sparingly after each feeding (except the feeding when the mother uses gentian violet). “Sparingly” means that the nipple and areola will shine but you won’t be able to see the ointment. Do not wash or wipe it off, even if the pharmacist asks you to. I used to use nystatin ointment or miconazole cream (15 grams) as part of the mixture, and these work well enough, but I believe the use of powdered miconazole (or even clotrimazole powder) gives better results. These ointments can be used for any cause of nipple soreness (“all-purpose nipple ointments”), not just for Candida (yeast). Use the ointment until you are pain-free and then decrease frequency over a week or two until stopped. If you are not having less pain af-ter 3 or 4 days of use, or if you need to be using it for longer than two or three weeks to keep pain free, get help or advice.

Vinegar Wash: 1 cup water and 1 tablespoon of vinegar. Use at least 4 times per day, after nursing. Use a clean cotton ball/swab to apply every time and let air-dry.

Cut back on your sugar intake. Yeast loves sugar, so the less that is in your body, the less the yeast has to thrive on.

Sterilize anything that goes into your baby’s mouth or has contact with your nipples. This is necessary to kill the yeast that is on those items and prevent it from reinfecting you. This includes any toys, pacifiers, bottle nipples, breast pump parts and your bras.

Wear disposable breast pads. Change them with each nursing and just toss them out. This way, you’re not sterilizing your bra every night.

Some moms have found swimming in a chlorinated pool to clear up their nipple yeast very quickly.

Diflucan/fluconazole is a prescription medicine that is commonly used to treat vaginal yeast infections. It has been shown to be effective against nipple yeast/thrush, especially when the yeast has survived all other treatments or it is a ductal yeast infection (meaning it is in your milk ducts, not just in the nipple area). The dosage for proper treatment is: 400mg loading dose on day one, then 200 mg per day for 13-28 days after, depending on what your health care provider designates as course of treatment.

2011 in review

The WordPress.com stats helper monkeys prepared a 2011 annual report for this blog.

Here’s an excerpt:

A San Francisco cable car holds 60 people. This blog was viewed about 2,300 times in 2011. If it were a cable car, it would take about 38 trips to carry that many people.

Click here to see the complete report.