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

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.

Preconception Counselling

Becoming a parent is a major commitment in life. It can be met with challenges, rewards and informed choices. Before you conceive, be sure to incorporate a healthy life-style to ensure optimal health for mom and baby. Receiving preconceptional counseling and care can lay the ground work for a healthy lifestyle and healthy pregnancy. Good health before pregnancy can help you cope with the stress of pregnancy, labor and birth. Obtaining good health care before you conceive will help you throughout your pregnancy. It also provides you with the opportunity to find out your risks, treat any medical problems that may affect the outcome of your pregnancy and adopt or continue a healthy lifestyle.

If you are planning to conceive, schedule a preconceptional visit with your healthcare provider. Included in your visit is a comprehensive history of your health including: Family history and risk factors, your medical history, surgical history, medications that you are presently taking including vitamins, supplements, OTC (over-the-counter) meds; your diet and lifetstyle and any past pregnancies.

Your preconception visit is a time for you to ask questions. Do not hesitate to seek advice, discuss your concerns and your options. Your healthcare provider is there to provide information and guidance to help you make informed choices in your healthcare to help you obtain and maintain a healthy pregnancy.

Women who are planning to conceive should stop their form of birth control several months in advance. Even though methods vary in use, it may affect when your menses resumes and becomes regular. During this time you may also want to start taking a prenatal vitamin daily to ensure you are getting added vitamins and increased folic acid.

Your lifestyle includes diet, exercise, weight, substance use, living/working environment and infection history. Current immunizations are important to prevent any infections during your pregnancy that can harm you and your baby, even if you were vaccinated as a child (measles, mumps, rubella, polio, tetanus), you may not be immune now. If you are vaccinated prior to conceiving, you will be protected. The vaccine for mumps, measles and especially rubella should be given at least 3 months prior to conceiving. During this period of time, you should use a reliable method birth control.

Optimal health at any time during your lifetime involves a healthy diet and the proper amount of exercise. Ideally, you should be in good physical shape and follow a regular exercise regimen before your conceive. If you are not used to being active, you should start an exercise program gradually.

Tobacco, alcohol and recreational (illegal) drug use is addictive and can harm you and your baby that can last a lifetime or even result in death. They can have detrimental affects on the organ formation, causing damage. The misuse of prescription medication can also harm the fetus. For the sake of your own health and that of your baby, now is a good time to cut back on smoking and alcohol and quit all recreational drugs. It takes time and patience to quit a habit, especially if you have had that particular habit for a long time. Ask your healthcare provider to suggest ways to get through the withdrawal state or quitting and to refer you to support groups. Your decision to quit may be one of the hardest things you have ever done, but it will be one of the most worthwhile.

Does your work environment impose any hazards? If you are trying to conceive, it is a good idea to look closely at your work place and surroundings. Are you exposed to toxic substances, chemicals, or radiation? Discuss your level of exposure to specific substances with your employee health division, personnel office or union representative.

Exposure to lead or certain solvents, pesticides or other chemicals can reduce your partner’s fertility by killing or damaging sperm. Unlike women, who are born with a complete supply of eggs for their entire lifespan, men make new sperm on a daily basis for most of their lives. Unless the damage to a man’s reproductive system is very serious, he will probably be able to make healthy sperm against a short time span after his exposure to the harmful material stops.

Healthy lifestyle choices during pregnancy are essential. Your health care provider will likely discuss the importance of a healthy diet, regular physical activity and keeping stress under control. If you’re underweight or overweight, your health care provider may recommend addressing your weight before you conceive.

Questions to Consider…
• Do I or a member of my family have a disorder that could be inherited?
• Do I need to gain or lose weight to prepare for pregnancy?
• Should I make any changes in my lifestyle?
• Could any medications I am taking cause problems during my pregnancy?
• Can I continue my present exercise program?
• Does my work expose me to things that could be harmful during pregnancy?
• Do I need to be vaccinated for any infectious diseases before I try to conceive?

What about your partner’s lifestyle?
If possible, have your partner attend the preconception visit with you. Your partner’s health and lifestyle — including family medical history and risk factors for infections or birth defects — are important because they can affect you and your baby.

Delaying Umbilical Cord Clamping

Clamping and cutting of the umbilical cord should be delayed for three minutes after birth, particularly for pre-term infants, suggests a senior doctor, Dr. Andrew Weeks, in the British Medical Journal. 28/08/2007.
Early clamping and cutting of the umbilical cord is widely practiced as part of the management of labor, but recent studies suggest that it may be harmful to the baby. Dr Andrew Weeks, a senior lecturer in obstetrics at the University of Liverpool, looked at the evidence behind cord clamping. For the mother, trials show that early cord clamping has no ill effects, he writes. But what about the baby?

At birth, he says, the umbilical cord sends oxygen-rich blood to the lungs until breathing establishes. When a baby is born it must transfer from receiving oxygen from the placenta to receiving oxygen from its lungs. For this to happen, the baby’s lungs must first expand, and the burst of blood from the umbilical cord helps to get the newborn’s lungs to expand properly. So as long as the cord is unclamped, the average transfusion to the newborn is equivalent to 21 percent of the neonate’s final blood volume and three quarters of the transfusion occurs in the first minute after birth. For babies born at term, the main effect of this large autotransfusion is to increase their iron status.

This may be lifesaving in areas where anemia is endemic. In the developed world, however, there have been concerns that it could increase the risk of abnormally high levels of red blood cells and bile pigments in the bloodstream often leading to jaundice. But trials show this is not the case.

Umbilical cord blood is a baby’s life blood until its birth. It contains stem cells, red blood cells, and more recently scientists have discovered that umbilical cord blood contains cancer-fighting T-cells.
For pre-term babies the beneficial effects of delayed clamping is greater, he says. Delayed clamping is consistently associated with reductions in anemia, bleeding in the brain, and the need for transfusion.
He proposes that in normal births, delaying cord clamping for three minutes with the baby on the mother’s abdomen should not be too difficult. The situation is a little more complex for babies born by caesarean section or for those who need support soon after birth. Nevertheless, it is these babies who may benefit most from a delay in cord clamping. For them, a policy of ‘wait a minute’ would be pragmatic, he says.

The World Health Organization’s (WHO) policy supports delayed cord clamping, stating:

“The optimal time to clamp the umbilical cord for all infants regardless of gestational age or fetal weight is when the circulation in the cord has ceased, and the cord is flat and pulseless (approximately 3 minutes or more after birth).”

They continue:
“Clamping the umbilical cord immediately (within the first 10 to 15 seconds after delivery) prevents the newborn from receiving adequate blood volume and consequently sufficient iron stores.
Immediate cord clamping has been shown to increase the incidence of iron deficiency and anemia during the first half of infancy, with lower birth weight. Waiting to clamp the umbilical cord allows a physiological transfer of placental blood to the infant which provides sufficient iron reserves for the first 6 to 8 months of life, preventing or delaying the development of iron deficiency …

For premature and low birth weight infants, immediate cord clamping can also increase the risk of intraventricular hemorrhage and late-onset sepsis.13 In addition, immediate cord clamping in these infants increases the need for blood transfusions for anemia and low blood pressure infants and infants born to iron-deficient mothers being at particular risk …

Numerous research studies and experts are also confirming that waiting to clamp the cord offers significant benefits. Among them:
• In the Journal of Cellular and Molecular Medicine, researchers say delayed cord clamping is “mankind’s first stem cell transfer and propose that it should be encouraged in normal births.”
• In a BMJ editorial, James Neilson, professor of obstetrics and gynecology, states that delayed clamping should be practiced.

Resources, Support:
“Early versus delayed umbilical cord clamping in preterm infants”. Rabe H, Reynolds GJ, Diaz-Rosello JL http://tinyurl.com/4w63wv8 (Cochrane Review)

http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be-standard-practice-in-obstetrics/

Oversupply of Breast Milk-What to Do

Concern about not having enough breast milk to feed your infant, is the number one reason that mothers wean their babies early, but having too much milk can also be a problem. When you consider the fact that a small percentage of women don’t have the capacity to produce enough milk for their babies no matter what they do, then
having too much milk is a relatively good breastfeeding problem to have, and is usually fairly easy to resolve.

When a mother has more milk than her baby can handle, the following behaviors may be common:
• Baby cries a lot, and is often very irritable and may become restless
• Baby may sometimes gulp, choke, sputter, or cough during feedings at breast
• Baby may seem to bite or clamp down on the nipple while feeding
• Milk sprays when baby comes off, especially at the beginning of a feeding
• Mom may have sore nipples
• Baby may arch and hold himself very stiffly, sometimes screaming
• Feedings often seem like battles, with baby nursing fitfully on and off
• Feedings may be short, lasting only 5 or 10 minutes total
• Baby may seem to have a “love-hate” relationship with the breast
• Baby may burp or pass gas frequently between feedings, tending to spit up a lot
• Baby may have green, watery or foamy, explosive stools
• Mother’s breasts feel full most of the time
• Mother may have frequent plugged ducts, which can sometimes lead to mastitis (breast infection)

Moms who produce too much milk may experience a few seconds of intense pain as the letdown (or milk ejection) reflex occurs, because it is so forceful. The cause of the problem is usually a combination of an overactive letdown reflex along with a foremilk/hindmilk imbalance. Let’s say that the ‘average’ mother has one half ounce of foremilk (the thin, sweet milk produced at the beginning of the feeding that is high in lactose but lower in fat) and two ounces of hindmilk (the higher calorie, thicker milk that is produced as the milk lets down and moves through the ducts, collecting fatty particles). This ‘average’ mother’s baby will get a total of about five ounces of milk if he nurses on both breasts. The mother with too much milk, on the other hand, may have an ounce of foremilk and three ounces of hindmilk in each breast. This
means that the baby may get four ounces of milk on the first breast, and if you switch him to the other side, he may be so full that he will only get the ounce of foremilk that comes out at the beginning of the feeding. This results in a disproportionate amount of foremilk. Why is this a problem?

Foremilk is high in lactose, a normal and necessary milk sugar that in large volumes causes gassiness and discomfort, frequently with green, watery or foamy stools. Over a period of time, undigested lactose can irritate the lining of the intestines, causing temporary secondary lactose intolerance and possibly small amounts of bleeding into stools that can be misdiagnosed as a food allergy. Adjusting breastfeeding to increase the amount of fat the baby receives (“finishing” the breast before switching) usually corrects the problem.

Here are some tips that can help you reduce and cope with an overabundance milk supply:
1) Offer only one breast at each feeding. Let your baby nurse as long as he wants to on that side. If he has nursed less than 15-20 minutes on that breast, and wants to nurse again in less than an hour or two, put him back on the same breast until he has stayed on for at least
15-20 minutes.
2) If he does nurse for 15 minutes or so on one side, don’t offer the second breast unless he seems to want it. He probably got all the milk he needed on the first side. Many babies (especially newborns) will take the other side if you offer it, not because they are hungry, but just because they love to suckle. If the other breast gets uncomfortably full before the next feeding, express just enough milk to relieve the discomfort, but not enough to empty it completely.
3) Try altering your nursing position. Lean back slightly, and hold him so that he is facing your breast, and straddling your leg, with his head elevated above our nipple. Lying on your side may be helpful as well. You also may try lying on your back, with your baby lying on top of you. In all of these positions, the force of gravity will reduce the flow of milk and let your baby control his intake more easily. If your baby is very small, try using the football hold, but make sure that his head is higher than the rest of his body. In any of these positions, you may want to use a towel or cloth diaper to catch the leakage,
because there will probably be some as the excess milk dribbles out of his mouth.
4) Try to relax during the letdown. Usually the milk will spurt out in forceful sprays in the beginning, and then slow down. You may want to catch the initial forceful sprays in a towel, put him on the breast after the sprays have settled down into steady drips. You many also want to express a little milk into a cup before you put him on the breast. Save this milk – it’s great for cereal later on. If your baby starts to choke or gag during a feeding, take him off the
breast, express a little milk, and then put him back on after he calms down.
5) Babies who gulp and choke when their mom has a forceful letdown will often swallow air. Burp him often, especially if you hear him continuing to gulp during the feeding. Don’t be surprised if he spits up a lot, especially while your supply is adjusting. Spitting up most often occurs in babies who are gaining weight well, but are taking in too much milk at a feeding. It’s usually more of a laundry problem than medical problem. However, if your baby spits up forcefully after every feeding, isn’t gaining weight well, or has other signs of illness such as fever or diarrhea, it may indicate a medical problem and you
should consult your healthcare provider.
6) Try to avoid pumping or expressing your milk unless you absolutely have to. Pump or express only if you need to relieve the fullness, because if you pump to empty your breasts, you may be more comfortable temporarily, but you will be sending your body the signals to make more milk.
7) Drink a cup of sage tea at bedtime. Sage contains a natural form of estrogen that can decrease your milk supply. Discontinue use when your supply begins to level out.
8) Usually within a week, you will notice a significant decrease in your supply as it adjusts to meet your baby’s demands without overproducing. You may findthat you need to use a pacifier if your baby wants to do a lot of ‘comfort sucking’.

If you do have a fussy baby who needs to nurse for comfort, offer the same breast during a two- hour period instead of switching sides every few minutes. Five minutes on one breast, then five on the other can result in him taking in too much foremilk, leading to symptoms of intestinal discomfort.

Usually, the problem of too much milk will resolve as your baby matures
and is able to handle the flow better, and also as your body settles down to make the milk your baby needs and not a lot extra. Like all other breastfeeding problems, this too shall pass.

excerpts from breastfeedingbasics.com

It’s Flu Season Again- Recommendations For Pregnancy

The Advisory Committe on Immuinization Practices (ACIP) recommends that pregnant and postpartum women recieve the seasonal influenza vaccine this year, even if they received the 2009 H1N1 or seasonal influenza vaccine last year. Lack of awareness of the benefits of vaccination and concerns about vaccine safety are common barriers to influenza vaccination of pregnant and postpartum women. To overcome these barriers, some key points have been provided in this document.

Influenza is more likely to cause severe illness in pregnant women than in women who are not pregnant. Changes in their immune system, heart, and lungs during pregnancy make pregnant women more prone to severe illness from flu as well as hospitalizations and even death. Pregnant woman with flu also have a greater chance for serious problems for their unborn baby including premature labor and delivery. Flu shots will protect pregnant women, their unborn babies and even protect the baby after birth.
The Flu Shot is the Best Protection Against Flu
Getting a flu shot is the first and most important step in protecting against flu. The flu shot given during pregnancy has been shown to protect both the mother and her baby (up to 6 months old) from flu. Pregnant women should receive the inactivated vaccine but not receive the live attenuated vaccine (nasal spray). Postpatum women, even if they are breastfeeding, can receive either type of vaccine.

The Flu Vaccine is Safe for Pregnant Women Flu shots are a safe way to protect the mother and her unborn child from serious illness and complications of flu. The flu shot has been given to millions of pregnant women over many years. Flu shots have not been shown to cause harm to pregnant women or their babies. It is very important for pregnant women to get the flu shot. The flu vaccine can be given in any trimester.

Pregnant women respresented 5% of the 2009 H1N1 influenza deaths in the U.S., while only about 1% of the population was pregnant. Severe illness in postpartum women was also documented. 2009 H1N1 is expected to continue to circulate this flu season and is included in the seasonal trivalent influenza vaccine this year.

It is best to get your flu vaccine as soon as it is available in your community. That’s because it can take two to three weeks for your body to develop antibodies to the flu virus after vaccination. If you get vaccinated in the fall, you will be protected by the time the flu season peaks, which is usually December through March. You will also be better prepared for the start of the flu season, which can begin as early as September or October.

One common myth about the flu vaccine is that it can actually cause the flu. Although the live vaccine does contain viruses, those in the flu shot have only inactivated pieces of the virus, and therefore, cannot cause infection.

Other Preventive Actions
In addition to getting the flu shot, pregnant women should take additional everyday preventive actions. Keep your distance from those who are ill; avoid crowds during peak flu season, if possible. That’s because flu viruses travel through the air in droplets when someone with the infection coughs, sneezes or talks. You can inhale the droplets directly or pick up the germs from common objects such as tabletops or doorknobs. Frequently wash your hands and avoid touching your eyes, nose and mouth. It is best to wash with soap and warm water for 15-20 seconds. YOu can also use an alcohol-based gel containing ast least 60 percent alcohol. Eat right and get enough sleep. A poor diet and lack of sleep can lower your immune system and make you more prone to infections.

Be sure to get your Vitamin D!! Get some sun exposure. A few times a week, 10 to 15 minutes of sun exposure on your face, arms, hands or back can help your skin create vitamin D naturally. The best dietary sources of vitamin D include liver, egg yolks, oily types of fish (salmon, tuna and sardines) and fortified milk. If you want to take a supplement, the US National Institutes of Health recommends the D3 form of Vitamin D which is much more effective than other types. D3 is a safe flu remedy and is available in 1,000 iu increments, over-the-counter, and at pharmacies and online retailers. Take 5,000 iu of D3 per day, for adults, when healthy to boost the immune system and prevent flu. Increase the D3 dose at the first sign of illness to 10,000 iu for adults. Drink water while taking D3. While unconfirmed, there have been rare reports of kidney stones as a result of vitamin D supplementation. This can be avoided with adequate fluid intake to maintain proper hydration.

Early Treatment is Important for Pregnant Women. If you get sick with flu-like symptoms call your healthcare provider right away. If needed, your provider will prescribe an antiviral medicine that treats the flu.
Having a fever caused by flu infection or other infections early in pregnancy can lead to birth defects in an unborn child. Pregnant women who get a fever should treat their fever with Tylenol® (or store brand equivalent) and contact their provider as soon as possible.

When to Seek Emergency Medical Care
If you have any of these signs, call 911 right away:
• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• High fever that is not responding to Tylenol® (or store brand equivalent)
• Decreased or no movement of your baby

Talk to your healthcare provider if you have any questions or concerns about the influenza vaccine.

Info provided from http://www.CDC.gov/flu
Mayo Clinic Women’s Health Source, Oct. 2010,. Volume 14, number 10

What is Mastitis? Cause, Treatment and Prevention

Mastitis occurs when bacteria enter your breast through a break or crack in the skin of your nipple or through the opening to the milk ducts in your nipple. Bacteria from your skin’s surface and baby’s mouth enter the milk duct and can multiply — leading to pain, redness and swelling of the breast as infection progresses.

Mastitis is often caused by Staphylococcus aereus and Escherichia coli bacteria. It is an unwelcome guest, especially to first time moms who have a difficult enough time trying to establish a breastfeeding routine with their baby. It is also unwelcome to those of you who have already experienced cracked nipples, have thin or sensitive skin, engorgement or a weakened immune system. Mastitis is often preceded by engorgement, plugged milk ducts or cracked and bleeding nipples.

Symptoms of mastitis include:
• A red, sore spot or “hot spot” on your breast
• Breast tenderness or warmth to the touch
• Swelling of the breast
• General malaise, or feeling ill
• Overall, flu-like symptoms
• Fever of 101 degrees F or 38.3 C or greater
• Red lines following the troubled milk duct’s path

Because many healthcare providers will prescribe antibiotics, it is up to the mother to find, in addition to the antibiotics, other remedies and comfort measures to help shorten the episode of mastitis, ease the pain and help to continue to breastfeed your baby.

Self-care remedies. Resting, continuing breast-feeding and drinking extra fluids can help your body overcome the breast infection. If you are prescribed an antibiotic, the course of therapy will usually be ten to fourteen days of antibiotics. Even though you may feel better after 48 to 72 hours of taking the antibiotics, be sure to finish the antibiotic regimen to ensure your breast infection is resolved.

To relieve your pain and discomfort:
• Maintain your breastfeeding routine-Yes; you can still breastfeed your baby with a breast infection. It is safe for you and for your baby. It is also recommended by the La Leche League to continue breastfeeding on the affected breast through mastitis to help shorten the episode of the infection and avoid abscesses. Mastitis need never be the reason to discontinue breastfeeding your baby
• Avoid prolonged engorgement before breastfeeding your baby. The mother needs to reduce the fullness as much as possible at each feeding to ease the inflammation and expel any milk plugs that may be present. Some babies may be reluctant to breastfeed on the infected breast because of elevated sodium content in the milk. If the baby cannot be persuaded to nurse, the mother needs to express milk to keep her breast soft.
• Use different positions to breastfeed your baby; sometimes the same position causes pressure points on a certain area of the breast, thus causing a plugged duct which can lead to mastitis. Be sure you are in a good and comfortable position before your baby latches on
• Drink plenty of fluids! Did I mention this before? This is important enough to repeat!
• If it is too painful to breastfeed on the affected breast and/or your breast is too sore to have babe latch on, you can pump and hand expressing your milk
• If you have difficulty emptying a portion of your breast, apply warm compresses to your breasts, take a warm shower, or kneel in your tub filled with warm water and submerge your breasts before breastfeeding your baby or pumping
• Wear a good supportive bra
• While waiting for the antibiotics to take affect, take a mild pain reliever such as acetaminophen (Tylenol, others) or ibuprofen (Motrin, Advil, others)

Prevention
Minimize your chances of getting mastitis by fully draining the milk from your breast while breastfeeding. Allow your baby to completely empty one breast before switching to the other breast during feeding. If your baby nurses only a few minutes on the second breast, or not at all, start breastfeeding on that breast at your next feeding.

Alternate the breast you offer first at each feeding, and change the position you use to breastfeed from one feeding to the next. Make sure your babe latches on properly before each feeding. If your baby is not latched on properly, break the suction with your finger. If baby fusses a few seconds, that is okay. This is better than you developing cracked nipples that can lead to mastitis.

Finally, do not let your baby use you as a pacifier. Babies enjoy sucking and often find comfort in suckling at the breast even when they are not hungry.

Breastfeeding your baby is the most fulfilling action in the mother-infant bonding process. It should be pain free and fulfilling.

by Angel J. Miller, MSN, CNM

Excerpts from Mayoclinic.com on Breastfeeding problems; La Leche League (lll.org)

Importance of Oral Health During Pregnancy

“Why do my gums bleed so much and so easily?” Oral health is a key component of overall optimal health and wellbeing across a person’s lifespan. During the course of pregnancy, it is very important to obtain treatment for your oral health and it IS safe throughout pregnancy. It is very surprising to find out that 22% of U.S. women reported they never accessed oral health care prior to becoming pregnant, and less than one third of pregnant moms visited their dentist in the postpartum period (between 2 to 9 months postpartum) following the birth of their babies. These statistics were obtained in a 2004 study. Surprising? Yes. Can it be prevented? Absolutely!

Why is oral health so important, especially during pregnancy? The many physiological changes that a woman’s body undergoes during pregnancy can have an undesirable affect on her overall oral health and good oral hygiene. The many hormonal changes that occur in pregnancy can increase the risk of the pregnant mom to be more susceptible to oral infections, such as periodontal disease, and can reduce the body’s ability to repair soft tissues in the mouth. In addition, “pregnancy gingivitis” or mild inflammation of the gums occurs in approximately 60% to 75% of pregnant women. If this condition is left untreated, it can lead to periodonitis, which can lead to bone and tooth loss. Periodontal disease has been associated with cardiovascular disease, stroke, poor diabetes control and adverse birth outcomes. The pain that results from oral disease can also harm nutritional intake and affect a pregnant woman’s self esteem.

While oral health is important to a women’s overall health, her oral health is also important in its relationship to the health of her unborn child. Studies have shown an association between periodontal disease and adverse birth outcomes such as low birth weight, preterm birth and gestational diabetes. More importantly, transmission of bacteria from the mother to her baby is the primary way that children first acquire the disease that causes cavities. Evidence suggests that most infants and most children acquire caries-causing bacteria from their mothers. Cavity-causing bacteria is passed through saliva via activities like sharing utensils, wiping off the baby’s pacifier in the mother’s mouth, and testing food before feeding to your baby. The healthier mom’s mouth, and the longer the initial transmission of bacteria is delayed, the more likely children are to establish and maintain good oral health.

Tips to help promote oral health:
• To help prevent or control tooth decay, brush your teeth with fluoridated tooth paste twice/day, and FLOSS DAILY
• Eat fruit, veggies, whole grain products and dairy products. Limit foods containing sugar to meal times only (watch those carbs!!)
• Drink plenty of water or low-fat/skim milk. AVOID carbonated beverages
• Choose fruit rather than fruit juice to meet the recommended daily intake of fruit (and will have less sugar)
• Obtain necessary oral treatment ideally before pregnancy. Those who have bleeding gums or cavities, should visit a dentist as soon as possible
• Diagnosis (including necessary dental x-rays) and treatment can be provided throughout pregnancy; however, the period between weeks 14 and 20 weeks of pregnancy is the best time to receive treatment.• Delaying necessary treatment could result in significant risk to the mother and indirectly to her baby

If you are dealing with morning sickness or frequent nausea, especially in the first trimester, here are some tips:
• Eat small amounts of nutritious foods throughout the day: the 6 small meals a day rule is important throughout pregnancy, but especially for dealing with nausea
• Chew sugarless or xylitol gum (causes bacteria to lose the ability to adhere to the tooth, stunting the cavity causing process) after meals.
• Rinse your mouth with water and a teaspoon of baking soda (sodium bicarbonate) after vomiting to neutralize acid
• Gently brush teeth with fluoridated toothpaste twice a day to prevent damage to demineralized tooth surfaces
• If you can’t brush your teeth because you feel sick, rinse your mouth with water or a mouth rinse that has fluoride

POSTPARTUM
For mom:
• Maintain good oral health
• Limit foods containing sugar to meal times only (watch sugar intake overall)
• Avoid saliva-sharing behavior, including:
Sharing spoons or other utensils
Cleaning a dropped pacifier or toy by putting it in your mouth

For Baby:
• After the first tooth erupts, wipe your baby’s teeth after feeding with a soft cloth or soft-bristled toothbrush
• Avoid putting your baby to bed with a bottle or sippy cup containing anything other than water
• Ask your baby’s healthcare provider about your baby’s oral health status
• Schedule your baby’s first dental visit for between ages 6 and 12 months

Promoting oral health during pregnancy is the solution to achieving overall health and well-being for pregnant women, their babies and families. Visit your dentist regularly and maintain good oral hygiene.

Article by Jessie Buerlein, MSW, Project Mgr, presented by Angel J. Miller, MSN, CNM
Quickening, Summer 2009. Volume 40, Number 3
Official Newsletter of the American College of Nurse Midwives

Submitted by the Improving Perinatal and Infant Oral Health Project, a joint effort of the American Academy of Pediatric Dentistry and the Children’s Dental Health Project. For more info please visit http://www.cdhp.org