Healthy Mom&Baby: Issue 31

ISSUE 31 / 2021 | $3.95 | health4mom.org

PREGNANCY | BIRTH | PARENTING

RESPECTFUL BIRTHING CARE WHEN PREGNANCY ALLERGIES STRIKE OUT OF HOSPITAL BIRTHING OPTIONS

WHY YOU NEED PRE- AND PROBIOTICS

MASSAGE YOUR BABY

GREEN CLEANING

For a Healthy Home

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Issue 31 / 2021

Contents ◆ healthy moms

◆ healthy pregnancy

◆ healthy babies

11 Your Voice Matters in Respectful Maternity Care

28 Managing Allergies and Asthma during Pregnancy

50 How to Bathe Your Premature Baby

Your voice matters when it comes to healthcare experiences.

Managing your allergies and asthma is essential for your baby.

13 Healthy Skin Care

30 Doula’s Speak Out: Helping Moms Reclaim Their Power During Birth and Beyond

Know which lotions and potions are healthy and best for your skin.

Learn about the role of doulas and their positive impact during pregnancy.

15 How Trauma May Affect Healthcare Visits This is why it is essential to share whether you have experienced trauma in care.

16 Transitioning from Incarceration to Wellness

We’ve got advice for rekindling the romance during and after pregnancy.

Follow these action steps to promote health as you navigate this life change.

35 Placenta Problems

20 Heal the Boy; Raise the Child Fathering isn’t easy if you didn’t have a dad; support can make all of the difference.

21 Can You Breastfeed with the Flu?

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32 How do I Fix a Decreased Sex Drive During or After Pregnancy?

The placenta is everything to your baby; here’s what it does.

39 Early Postpartum Exercise Begin your recovery from birth safely and effectively.

Protect yourself and baby by getting the flu shot.

42 Choosing Out of Hospital Birth With a Midwife

23 Get Rid of those Extra Baby Pounds

Consider the risks, benefi ts and alternatives when making a decision about where you want to birth.

Stay healthy after pregnancy with these top tips.

25 Supplements to Rebuild

45 Healing Sore Nipples Here’s how to manage those pains and twinges when beginning breastfeeding.

Calories and supplements can help boost postpartum nutrition.

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Healthy Skin Care

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53 15 Safe Sleep Tips for Baby The latest recommendations from the AAP will help baby sleep safely.

56 Teething 101 Help baby comfortably welcome their chompers.

58 To Cut or Not to Cut? The Circumcision Choice.

Learn all the risks and benefi ts of circumcision.

60 Infant Massage for Babies in the NICU Your little one can benefit from your touch with these therapeutic massage tips.

62 How to Conquer Potty Training It might get messy; you can be prepared.

65 Enjoying the Fall Season Baby needs fresh air and so do you.

66 Visitors & Your Baby During COVID It is important to keep parents and baby safe during COVID.

15 Safe Sleep Tips for Baby

Combatting Low Sex Drive During and After Pregnancy

42

Baby may be tiny but they still need a bath—here’s how.

Out of Hospital Birth

53 62 How to Conquer Potty Training ISSUE 31 / 2021 Healthy Mom&Baby

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HEALTHY MOM&BABY EDITORIAL ADVISORY BOARD LASHEA HAYNES MED, MSN, APRN, AGCNS-BC, RNC,C-EFM Editor Perinatal Potpourri, LLC Nurse Mentoring & Consulting Atlanta, Georgia PARIS MALOOF-BURY, MSN, CNM, RNCOB, IBCLC Associate Editor Sutter Women’s Health Davis, California MICHELE KACMARCIK SAVIN DNP, APRN, NNP-BC Thomas Jefferson University Philadelphia, PA JAMIE VINCENT, MSN, APRN-CNS, RNCOB, C-EFM, C-ONQS John Muir Health Walnut Creek, California JOANNE GOLDBORT, PHD, RN Michigan State University College of NursingEast Lansing, Michigan ALIAH THOMAS, RNC-OB Wellstar Health System Atlanta, Georgia ESSENCE WILLIAMS, MSN, BSN, RNCMNN, CCB, LCCE Southern New Jersey Perinatal Cooperative (SNJPC) Crum Lynne, Pennsylvania KIMBER STOVESAND, RN Nomad Health Charlotte, North Carolina LAKISA BALLARD, MSN, RN, C-EFM, RNC-OB Perinatal Travel Nurse Charlotte, NC SHAWANA S. MOORE, DNP, MSN, CRNP, WHNP-BC Thomas Jefferson University, College of Nursing Philadelphia, PA RACHEL NAPOLI, DNP, PHN, CNS, RNCOB, IBCLC Sonoma State University Petaluma, CA JESSICA MCNEIL, DNP, APRN, CNM, RNCOB, C-EFM Parkland Health & Hospital System Baylor University, School of Nursing Dallas, TX HEATHER WATSON, PHD, MSN, RN Johns Hopkins Health System Baltimore, MD DANIELLE BEASLEY, PHD, RN, RNC-OB, CNE University of South Florida Tampa, FL CHARLOTTE WOOL, PHD, RN, FAAN York College of Pennsylvania York, PA JENNIFER LEMOINE, DNP, APRN, NNPBC Southeastern Louisiana University Hammond, LA RITA NUTT, DNP, RNC-OB Salisbury University Salisbury, MD SHARON HITCHCOCK, DNP, RNC-MNN University of Arizona College of Nursing Tucson, Arizona

AWHONN’s mission is to improve and promote the health of women and babies.

Healthy Mom&Baby is powered by the nurses of AWHONN.

COVID-19 Vaccines Are Pregnancy Protective

By Cyndy Krening, CNS, RNC-OB, C-EFM

As researchers continue to observe the effects and outcomes of the COVID-19 vaccination among pregnant people, the results are reassuring that it’s safe and important to get vaccinated in pregnancy.

Now, a large study just published in the New England Journal of Medicine, has busted the myth that COVID-19 vaccination may increase miscarriage or pregnancy-loss. In fact, COVID-19 vaccination was found to be protective of both the pregnant person and their developing baby both during pregnancy and post-birth.

This protective effect was true for all the three major COVID-19 vaccines: Pfizer, Moderna and AstraZeneca.

The authors of the study, “Covid-19 Vaccination during Pregnancy and First-Trimester Miscarriage,” stressed it’s important for pregnant persons to get vaccinated because they’re at a high risk of hospitalization and COVID-19 complications. And their developing babies are at a high risk of being born too early.

COVID-19 Vaccines Protect Both Mom & Baby Experts at the Centers for Disease Control & Prevention have consistently urged women contemplating pregnancy, or who are pregnant, to get vaccinated as COVID-19 vaccination accomplishes the following:  Reduces risk of infection and illness among pregnant and recently pregnant people, who are more likely than non-pregnant people to get severely ill with COVID-19  Protects both the pregnant person and baby from severe illness  Is recommended for all people 12 years and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future  Aligns with the increasing evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy. This data suggests that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks of vaccination during pregnancy

CYNDY KRENING, MS, CNS, RNC-OB, C-EFM is the 2021 AWHONN president.

ISSUE 31 / 2021 Healthy Mom&Baby

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AWHONN AWHONN 2021 President

Cyndy Krening, MS, CNS, RNC-OB, C-EFM Chief Executive Officer

Improving Maternal Outcomes for Moms!

By LaShea Haynes MEd, MSN, APRN, AGCNS-BC, RNC, C-EFM

Jonathan Webb, MPH, MBA Senior Vice President, Strategic Partnerships, Communications & Meetings

Billie Robinson, MBA, CAE Editor-in-Chief & Senior Director, Strategic Partnerships & Publications

Carolyn Davis Cockey, MLS, LCCE Editor

LaShea Haynes MEd, MSN, APRN, AGCNS-BC, RNC,C-EFM Associate Editor

Paris Maloof-Bury, MSN, CNM, RNC-OB, IBCLC Assistant Managing Editor

Sofia Navard MAITLAND WARNE Group CEO & Publisher

Kevin Harrington Sub Editor

Emmanuel Berhanu Design

Friyan Mehta Production Director

Joanna Harrington Production

Delicia Tasinda Cover image

© Ariel Skelley | Getty Images Healthy Mom&Baby is published by Maitland Warne in partnership with AWHONN. © AWHONN, 2021. All rights reserved. All material in Healthy Mom&Baby is wholly copyright.

Reproduction without the written permission of AWHONN is strictly forbidden.

Neither this magazine nor its contents constitute an explicit or implied endorsement by AWHONN or by Maitland Warne of the products or services mentioned in advertising or editorial content.

The editorial content in this publication does not necessarily represent policies or recommendations

by AWHONN. This publication is not intended to be exhaustive. While every effort has been made to ensure accuracy, neither AWHONN nor Maitland Warne shall have any liability for any errors or omissions. Readers who may have questions should consult their healthcare provider.

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It’s Fall Ya’ll, and as the temperature changes, the leaves transition from green to beautiful autumn shades and there is a crisp breeze in the air. As dependable as the season changes month after month, year after year, we can also count on a mother’s body to conceal and grow that thriving embryo into a fetus and then birth a new bundle of joy.

There are many things in life that change and grow, but one of the things that remains the same from the beginning of time is a mother’s intuition. From things like counting your baby’s kicks in the womb, to ensuring the baby’s doing OK in there, to choosing the most dependable car seat, to bringing your baby home safely. Your ability to discern what’s best for you and your growing family is why we are both here!

This edition will not disappoint you; it will provide you with the same level of knowledge, tips, survival guides and information you can count on! Remember for the extended version of these articles, or further content on your favorite topics, to go to www.health4mom.org. Also, please follow us on Facebook and Instagram as well for news, updates, and live discussions on your favorite topics.

I want to thank you for supporting our magazine and send a special hello from our amazing editorial advisory board. They have really outdone themselves with these articles that are sure to keep you engaged and supported in your journey of pregnancy, motherhood and the first few years of parenthood. Take comfort in knowing our articles are evidence-based and written by the educated, professional and passionate nurses of AWHONN. Stay safe during these uncertain times and know we are still here for you!

Yours Truly,

LaShea

LaShea Haynes, MEd, MSN, APRN, AGCNS-BC, RNC, C-EFM

Editor, Healthy Mom&Baby

EDITOR IAL INQUIR IES

AWHONN Sofia Navard snavard@awhonn.org www.AWHONN.org

ISSUE 31 / 2021 Healthy Mom&Baby

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Breastfeeding May Be Neuroprotective, Mama

On the fence about nursing that little bun in the oven?

You may not want to miss the brain-boosting benefits of breastfeeding for you.

A new study led by researchers at UCLA Health has found that women aged 50 and older who had breastfed their babies performed better on cognitive tests compared to women who had never breastfed. The findings, published in Evolution, Medicine and Public Health, suggest breastfeeding may have a positive impact on your postmenopausal brain and cognitive performance.

The benefits for babies who are breastfed are abundant and well documented. This is one of the first studies that looks at the long-term health effects for women who breastfeed their babies,” said Molly Fox, PhD, lead author of the study and an Assistant Professor at UCLA. “Our findings, which show superior cognitive performance among women over 50 who had breastfed, suggest that breastfeeding may be ‘neuroprotective’ later in life.”

Great brain health is essential for aging well. When cognition is less than optimal, those losses can be a strong predictor of Alzheimer’s disease (AD), which is the leading form of dementia and cause of disability among the elderly – with women comprising nearly two-thirds of Americans living with the disease.

“What we know is that there is a positive correlation

between breastfeeding and a lower risk of other diseases such as type-2 diabetes and heart disease, and that these conditions are strongly connected to a higher risk for AD,” said Helen Lavretsky, MD, senior author of the study and a professor at UCLA. Because breastfeeding also helps moms cope with stress, boost infant bonding and decrease the risk of postpartum depression, researchers acted on a hunch that it could also likely lower the risk of AD. Key findings from the analysis of the data collected revealed that about 65% of non-depressed women reported having breastfed, compared to 44% of the depressed women. All non-depressed participants reported at least one completed pregnancy compared to 57.8% of the depressed participants.

Results from the cognitive tests also revealed that those who had breastfed, regardless of whether they were depressed or not, performed better in all four of the cognitive tests measuring for learning, delayed recall, executive functioning and processing compared to women who had not breastfed.

Interestingly, the researchers also found that longer time spent breastfeeding was associated with better cognitive performance. When they added up all the time a woman spent breastfeeding in her life, they found that women who had breastfed the longest had the highest cognitive test scores.

ISSUE 31 / 2021 Healthy Mom&Baby

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healthy moms

Your Voice Matters in Respectful Maternity Care

By Shawana S. Moore, DNP, MSN, CRNP, WHNP-BC

2

What Matters to You

3

Information Sharing

4

Your Voice Matters

#

Let your healthcare team know what matters to you. Clearly and confidently communicate with your healthcare team every step of the way about what matters to you. It doesn’t matter how small or large your request may seem. If it’s important to you, tell your team. Your healthcare providers should make every effort to ensure that the things that matter to you are incorporated into your care plan.

#

Information should be openly shared with you and your family throughout your care.

If anything is ever unclear or not explained by your healthcare team, be sure to ask questions and seek clarity about the care you’re receiving.

Your healthcare team should be more than willing to continuously share information regarding your plan of care.

If you’re unsure or have questions about your care, please use your voice and ask questions so that you can understand the benefits versus risks in the care you’re receiving. Information should always be shared with you in a culturally appropriate manner and in your preferred language.

images: Images frozen in time by Khrishna Bomar

Y

ou deserve respect and supportive health care throughout your life. From pre-pregnancy, prenatal, childbirth, postpartum, routine well person, and sick care, your visits should always put you at the center of importance with respectful care.

Your voice matters throughout all your care experiences. You should be heard, and your concerns should be validated by your healthcare team.

Use these 3 strategies to ensure you receive the care you deserve.

1

#

Introduce Yourself

Introduce yourself to the healthcare team and let them know by what name you like to be addressed. Ask to meet your care team; knowing who is on your team and the role they play will help you and your family understand who is facilitating each part of the care you receive.

Introducing yourself to the team allows them to learn about you. You are not just a name on a piece of paper or a patient in an exam room. You are a person with important beliefs and values from a family and a community of people.

#

Respectful care is a human right for all persons regardless of ethnicity, race, gender identity, sexual orientation, socioeconomic status, religion, beliefs, or values. You have every right to respectful care. Using your voice is one critical way to ensure you receive respectful care from your healthcare team.

Shawana S. Moore , is a women’s health nurse practitioner. She serves as an Assistant Professor and the Director of the Women’s Health Gender-Related Nurse Practitioner Program at Jefferson College of Nursing. She is passionate about equitable, respectful, and inclusive maternal-child care.

ISSUE 31 / 2021 Healthy Mom&Baby

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healthy moms

Healthy Skin Care

By Paris Maloof-Bury, MSN, CNM, RNC-OB, IBCLC

A

t Healthy Mom&Baby, we’re all about health. And just like you, we like to look good, too.

So, when it came time to write about the lotions and potions we use on our skin, we asked women’s health nurse-midwife expert and ingredient advocate, Charlette Withers, CNM, RN. Withers is passionate about why we need to care about the products we put on our skin: “What we put onto our skin is so important, because our skin is the gateway to what goes into our bodies and our system as a whole.”

What ingredients should we be concerned about?

Withers: Lead, for one. It’s very common in lipsticks. And you should also be on the lookout for formaldehyde, parabens, and PEG as well. They’re all common ingredients in beauty products.

What do we need to know to protect ourselves from hidden ingredients?

We’re not ready to give up our lipstick, we like to look good!

Withers: Me neither! What you need to do is choose products that are as clean as possible. What I mean when I talk about clean beauty is products that are void of anything harsh or toxic like those ingredients I just mentioned, as well as alcohols, hydroquinone, and synthetic flavors or fragrances.

But so many lip balms have flavors.

I remember wearing cherry flavored lip gloss when I was a teenager. It makes me so sad to think that all that time I was putting something onto my lips that might have caused harm. How can we protect ourselves and our families?

Withers: I highly recommend checking out Beautycounter’s The Never List™, which is a list of ingredients to watch out for. Another helpful tool is the Environmental Working Group’s EWG Healthy Living App, a free app that allows you to actively scan products at home or before you buy them. After all, knowledge is power, and power is beautiful!

Paris Maloof-Bury, MSN, CNM, RNC-OB, IBCLC, is Associate Editor of Healthy Mom&Baby and a certified nurse-midwife in Northern California who loves helping parents grow their families with love, support, safety, and empowerment.

images: Dreamstime

Why should we be concerned about what ingredients are in our skin care products?

Withers: Knowing what ingredients are used, and what potential side effects those ingredients can cause can help us understand the issues and complications we have going on with our health and with our bodies.

Many skin care products contain endocrine disruptors. Endocrine disruptors are chemical compounds that can interfere with your body’s normal hormonal function. Some of these can cause cancerous tumors, birth defects, and other developmental disorders.

Oh, wow! You’re telling me my face cream can cause my baby to have birth defects?

Withers: Yes. Some of the ingredients can absolutely cause harm in that way, such as BPA and phthalates. There is also evidence that some ingredients may contribute to infertility and to early menopause.

ISSUE 31 / 2021 Healthy Mom&Baby

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How Trauma May Affect

Healthcare Visits

Are you a victim of sexual assault? Domestic violence?

You may benefit from trauma-informed care

Receiving TraumaInformed Care Use these tips to seek traumainformed care. Healthcare providers who practice traumainformed care will:

By Jessica McNeil, DNP, APRN, CNM, RNC-OB, C-EFM

A

nxious about routine cervical exams and Pap smears? A 2019 study by Cornforth found a significant number of women ages 18-71 reported feeling at least some anxiety during gynecological exams.

For some, though, a pelvic exam can be so paralyzing they avoid care. If you’ve had traumatic experiences, you may benefit from receiving traumainformed care.

What is Trauma-Informed Care?

Trauma-informed care assumes most people have experienced some form of trauma. It uses actions and techniques to avoid re-traumatizing a person.

Healthcare providers who practice trauma-informed care have received training to help them recognize the signs that a person may have experienced a form of trauma. They’re able to modify care to minimize retraumatizing you.

Principles of Trauma Informed Care XX Individuals feel physically and psychologically safe XX Healthcare decisions build and maintain trust, and ensure that the person is the primary decision-maker XX Individuals receive access to peer support and can connect with others with similar experiences XX Your healthcare provider collaborates with other members of your care team XX Individuals are empowered to recognize their own strengths, and ability to heal and overcome past traumas XX Biases in relation to race, sex, gender, religion, etc. that a person may have experienced are affirmed and acknowledged

hh Give you as much time as you need to emotionally prepare before beginning any physical care or examination hh Tell you exactly what they are going to do before doing it, and wait for your permission to proceed hh Encourage you to sit up during a pelvic exam as opposed to laying on your back hh If it helps you maintain control or feel comfortable, they may have you put your hand over theirs during your exam hh During childbirth they will encourage you to give birth in whatever positions feel most comfortable and effective for you

Jessica McNeil, DNP, APRN, CNM, RNC-OB, C-EFM is a certified nurse-midwife at Parkland Hospital in Dallas, TX, and an adjunct professor at Baylor University, and an expert adviser to Healthy Mom&Baby.

images: Dreamstime

Be Your Own Advocate The main thing you can do to have a positive health care experience is to be your own advocate. Find a healthcare professional that you trust, and who listens to your needs and concerns. Ask if they’re familiar with trauma-informed care, and share your experiences or concerns, as desired.

During trauma-informed care you should always feel respected and in control. You may never look forward to your annual well-woman exam, but it doesn’t have to be an experience that gives you anxiety or leaves you feeling re-traumatized.

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Transitioning from

Incarceration to Wellness These are the essential women’s health exams you’ll need to become and stay healthy

By Shawana Moore

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T

wo-thirds of women incarcerated are in their childbearing years, chiefly ages 18 to 40, according to the Federal Bureau of Prisons. Transitioning back into the community is a time of celebration and of reunion. It’s also an opportunity if you’ve been incarcerated to refocus on your health as you get back to living your best life.

Specific health recommendations, screening guidelines, and resources will vary depending on your age. If you’re between 21 and 39 years old, this article is for you.

Getting health care that helps you prevent illness is vital to staying healthy and well. As soon as you’re able, schedule an appointment with a nurse-midwife, women’s health nurse practitioner, gynecologist, or a family doctor. And plan to get regular care.

At your first visit, your care provider will screen for medical problems, assess your risk for future medical issues, make sure your vaccinations are up to date, and empower you to lead a healthy lifestyle, all while building a professional and helpful relationship with you.

images: Dreamstime

Getting Back to Regular Life Look for “re-entry programs” in your community. These programs help connect folks to health care, employment, education, and housing, and improve public safety. The Lion Heart Foundation at Lionhart.org provides a list of reentry programs throughout the country. The federal Substance Abuse and Mental Health Services Administration, SAMHSA. gov, has an excellent resource entitled, After Incarceration: A Guide to Helping Women Reenter the Community online.

Protect Your Health Each Day It’s so important for you to take care of yourself on a daily basis. Eat healthy foods, exercise at least 30 minutes every day, take a multivitamin with 400 to 800 mcg of folic acid, and get at least 7-9 hours of sleep each night.

Ask your healthcare provider for help if you need to get to a healthy weight.

Stay tobacco-free, and if you need help quitting smoking or vaping, your

provider can help you with that, too!

Try to limit alcohol use to 1 drink or less each day and avoid illegal drugs or misuse of prescription drugs altogether.

And while you’re at it, be sure to wear the appropriate protective gear for sporting activities (helmets), and a seatbelt whenever you’re in a car.

We want you to be well and to make the very most of your well-deserved freedom!

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healthy moms

Healthcare Checklist Use the following guides to ensure you have a comprehensive well-person exam.

Women and People with Internal Genitalia, Ages 21-39 Sexual History Your sexual history focuses on the CDC’s Five P’s. You may ask about the following: hh Partners (Who are your sexual partners?) hh Practices (What kind of sexual contact do you have?) hh Protection from STDs (Do you use any protection against STDs?) hh History of STDs (Have you ever been diagnosed with an STD?) hh Prevention of pregnancy (Are you currently trying to conceive a child?

Are you using birth control?)

Physical Exam A physical exam will likely include: hh Height hh Weight hh Body Mass Index (BMI) hh Blood Pressure hh Thyroid Exam hh Breast Exam hh Abdominal Exam hh Pelvic Exam hh Skin Exam STD/STI Screenings hh If you’re ages 21-25 and sexually active, you’ll be screened for chlamydia and gonorrhea. If you’re older and are potentially at high risk for one of these infections, you should be screened. Be sure to ask if it isn’t offered! hh A one-time test for hepatitis is recommended for all adults. hh You should have at least one screening for HIV, and be screened more often if you’re at risk for HIV Vaccines hh Human Papillomavirus (HPV): 3 lifetime doses

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hh Influenza: Every year hh Tetanus, Diphtheria, Pertussis: Booster every 10 years hh Varicella: 2 lifetime doses if you’re not already immune hh Measles, Mumps, Rubella: At least 1 or 2 lifetime doses unless you have a medical contraindication or evidence of immunity

Preventative Health Screenings Breast Cancer Screening hh People with breasts should have a clinical breast exam every year hh Experts don’t agree on the benefits of self-breast exams in finding cancer however, it is vital to be aware of that your breasts normally look and feel like hh Contact your health care provider if you notice changes in your breasts at any time hh Mammograms aren’t typically recommended for people with breasts until age 40 hh If you have a strong family history of breast cancer at a young age, annual mammograms might be considered earlier Cervical Cancer Screening hh People the ages of 21-29 who have a cervix should have a Pap smear every 3 years. HPV testing is not recommended for this age group hh People ages of 30-65 should be screened with either a Pap smear every 3 years or with both a Pap smear and the HPV test every 5 years hh People treated for cervical dysplasia (precancer) should continue to have Pap test every year for 20 years post-treatment or until age 65 (whichever is longer)

Depression: Your provider should screen for depression at least once every year Intimate Partner Violence: Your provider should screen for intimate violence partner violence at every visit Diabetes Screening hh If your blood pressure is elevated (130/80 or higher), your provider may test your blood sugar levels for diabetes hh If you have risk factors for diabetes such as a history of gestational diabetes, a first degree relative with diabetes, or a high BMI, then your provider may screen for diabetes Cholesterol Screening hh Recommended beginning at age 20 for people with known risk factors for coronary heart disease hh Testing should be repeated every 5 years for people with normal results Blood Pressure Screening hh Your blood pressure should be checked at least once every 2 years hh If you have other medical conditions (such as kidney problems, heart disease, or diabetes), your blood pressure should be checked more frequently Dental Exam hh You should have a dental exam and cleaning once or twice every year Eye Exam hh You should have an eye exam every 2 years, or more often if you have visual problems or diabetes Shawana S. Moore is a women’s health nurse practitioner. She serves as an Assistant Professor and the Director of the Women’s Health Gender-Related Nurse Practitioner Program at Jefferson College of Nursing.

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Nobody likes to be rushed, especially babies.

Your baby needs at least a full 40 weeks of pregnancy to grow and develop. Inducing labor even a week or two early is associated with a host of risks, including prematurity, cesarean surgery, hemorrhage and infection.

While it may seem convenient for you or your health care provider, labor should only be induced for medical reasons.

Your baby will let you know when she’s ready to come out, so give her all the time she needs: at least the full 40 weeks.

Download a free copy of

40 Reasons to Go the Full 40 at www.gothefull40.com.

The nurses of AWHONN remind you not to rush your baby—give her at least a full 40 weeks!

AWHONN PROMO T I NG T H E H E A LT H OF WOMEN A ND NE W BOR NS

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healthy moms

Heal the Boy; Raise the Child “Fatherless” fathers benefit from getting mental health support before baby is born

By Dr. JL Adolph

Fatherhood Fears Fathers are often left wondering if they will do a good job. Do you have what it takes? You might feel an ice block in the pit of your stomach—heart-racing anxiety that may make some dads want to run. While you cannot wait to smell the sweet scent of your baby boy or daddy’s little girl; no matter how hard you try, you become triggered by unresolved father loss trauma.

The forgotten boy left waiting on the stoop—the lost boy playing catch by himself. The boy learning to tie a bowtie from an uncle, coach, or spiritual father while wishing his biological father would take his rightful place at his doorstep.

Suppose the boy happens to be Black, Indigenous or a Person of Color (BIPOC) in America. In that case, you might be scarred by the ever-sharpened edges of re-publicized myths about the Black absentee or “deadbeat”

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African American father. The purpose of this article is not to sensationalize the horrors of soon-to-be fatherless fathers. It is quite the opposite; this article encourages fatherless fathers to heal the boy; raise the child.

Preparation for Fatherhood The expression, “heal the boy; raise the child,” pleads for fatherless fathers to seek mental healthcare before their children enter the world. As first-time dads, you may be unaware of the devastating impact intergenerational trauma, meaning trauma passed down through generations like family heirlooms, can have on a child.

According to social work expert Edward Kruk in, “Father Absence, Father Deficit, Father Hunger,” fatherless children are at increased risk of experiencing the following traumas:  Diminished self-concept and compromised physical, emotional security  Behavioral problems  Truancy and poor academic performance  Delinquency and youth crime  Promiscuity and teen pregnancy  Drug and alcohol abuse  Homelessness  Exploitation and abuse  Physical health problems  Mental health disorders

Get Help Before Baby is Born Given that countless fatherless fathers who endured or overcome these traumas remain silently terrified, they will pass these atrocities consciously or unconsciously to their infants. Hence, these dads must get the help they need before they hold their bundles of joy.

A good therapist may help new fathers to learn the trauma they underwent was not their fault, but it is their responsibility. Without question, fatherless fathers with a good emotional support team will develop the skills necessary to heal from the trauma of father loss. Through mental healthcare, fatherless fathers can break generational curses by learning to love themselves and embracing their vulnerabilities. Dads with this brand of emotional intelligence can give their children a map they never received.

If you are a first-time fatherless father, please get the support you need by looking up fatherhood experts on websites like Psychologytoday.com, Perinatalpotpurri.com, Postpartum.net, and www.mentoheal.com.

DR. JL ADOLPH is an associate professor of English at Georgia State University, Perimeter College, who focuses on fatherhood in Hip-hop and culture. Also, he is the lead vlogger of a DadCypher: A Hip-hop Guide to Fatherhood, a YouTube channel that discusses fatherhood.

IMAGES: DREAMSTIME

F

or most dads, the joy of being a first-time father is exhilarating, often rekindling a long-lost barefoot childhood filled with football, video games, and adventures of hide and seek. But for novice fathers who grew up fatherless, those reels of rug rat pleasures are often interrupted by a gnawing fear. The fear of the unknown.

How can I be expected to navigate the roads of fatherhood with a GPS, road map, or a homemade sketch?

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healthy moms

Can You Breastfeed with the Flu?

By Catherine Ruhl, CNM, MS

W

IMAGES: DREAMSTIME

ith the flu season in full swing, you may be wondering how safe it is for you to feed and care for your baby if you get sick.

First, you should know it’s important that you get a flu shot to protect yourself against this disease.

When you’re breastfeeding, it’s safe for you to get either the shot or the nasal spray vaccine. If you’re concerned about the preservative thimerosal in flu shots, ask for a thimerosal-free vaccine.

This year it’s especially important that you also get the COVID vaccine, particularly if you’re still pregnant when you’re reading this article.

The flu isn’t the only infectious disease you need to try to prevent.

The CDC notes that all vaccines, except the smallpox vaccine, are safe while breastfeeding. Vaccines can provide

some protection to your baby because they’re designed to protect against bacterial infections that may pass though breast milk.

painful breast infection. Cold medicine can be drying, so drink extra fluids to keep up your milk supply.

Feeding with the flu

Breastfeeding is all the more important to continue if your baby is sick. In fact, you will need to breastfeed more often so your baby can get the fluids and nutrients they need to replace those lost due to illness. Breastfeeding, always comforting to your baby, is even more so when they are sick. If your baby has a cold, nursing him or her in an upright position may be helpful. Of course, you should talk to your baby’s health care provider when your baby is ill if you have questions, especially if he or she has a fever, diarrhea, is vomiting, or won’t breastfeed.

Make sure that you take extra care to wash your hands well (ideally, for the length of time it takes to recite the “ABCs” in your head) when any family member is ill. Oh, and one more thing – don’t forget to get the rest of your family vaccinated so they don’t bring the flu home and increase the risk of you or the baby getting it.

Even if you get the flu, in most cases it’s best to continue breastfeeding because your baby will gain protection from antibodies in your breast milk. In fact, with most viral infections, such as colds, sore throats, and stomach viruses, you are infectious but starting to produce antibodies before you have any symptoms. So, if you don’t interrupt breastfeeding, your baby gets protection both before you knew you were sick and throughout your illness. And don’t worry; these common viruses are not passed to your baby through your milk.

If you aren’t up to nursing your baby for a feeding or two, have your partner or a friend feed your baby a bottle of your pumped breast milk. Check with your healthcare provider to see what medications you can take for your symptoms, as many over-the-counter cold and flu remedies are safe during breastfeeding.

Maintain your milk supply by nursing or pumping regularly during your illness. If you don’t, your breasts can become hard and engorged and lead to mastitis, a

What if baby gets sick?

Flu-Free and a Mom-to-Be The “Flu-Free and a Mom-to-Be” campaign is a joint initiative of HealthyWomen and the Association of Women’s Health, Obstetric and Neonatal Nurses. The campaign is supported by CSL Biotherapies.

Click here for more information on the campaign.

CATHERINE RUHL, CNM, MS is a certified nurse-midwife in Albuquerque, New Mexico.

ISSUE 31 / 2021 Healthy Mom&Baby

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What can I do about Scars?

Is your scar significant? Problem scars are the result of an impasse in healing. Successful scar management assist in overcoming these pauses in healing.

surgery removes scar tissue and lessen the tension across the scar. Also effective is professional skin resurfacing through chemical, laser or micro needling.

Problem or “angry” scars can be swollen, contracting, itchy, painful, causing discomfort and psychological distress. For over 25 years ReJuveness has help the medical community and over 200,000 patients resolve and prevent problem scars.

ReJuveness offers a much less expensive at home micro-needling alternative. All scar revision professional or self-applied can yield improved results when used in conjunction with ReJuveness products.

Less severe scarring and stretch marks can raise cosmological concerns. Uneven skin texture and coloring is normal but undesirable. The solution to these otherwise healthy mature scars is to restimulate the healing process.

Expensive Scar Revision

Little scientific evidence exists why standard scar treatments work. It has been found using multiple treatments at once improves results. Scar management principles are: 1. Start scar management early 2. Reduce tension across the scar 3. Promote rapid skin resurfacing 4. Silicone sheeting is the nexus of scar management 5. Certain silicones are more effective for scar management Get a personal scar evaluation by contacting a ReJuveness Scar Advisor. Email your scar description and questions to scar.advisor@rejuveness.com or call 518-623-Heal (4325) Heal Scars!

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healthy moms

Get Rid of those Extra Baby Pounds 4 Tips for Resetting Your Body Post-Pregnancy

By Lakisa Ballard, MSN, RN, C-EFM, RNC-OB

C

an we all agree that after having a baby our diet is not necessarily our top priority? Adjusting to a new baby, new schedule, and new responsibilities can feel overwhelming at times. But as nurses, we are here to give you a gentle reminder that your health matters, and that a healthy diet isn’t just important prior to conception but should continue all the way through postpartum recovery and beyond.

We know that we all miss the target sometimes; that’s just part of being human. But we’ve got you! Once your baby is here and your parenting journey begins, here are a few ways to help stay on target and get rid of the extra baby fat.

images: Dreamstime

Drop the Pregnancy Pounds: Drink More Water One of the biggest and most natural ways to lose weight and body fat is to increase your water intake. Whether you like it at room temperature, hot, or iced, our bodies need it. Hydration is essential to the function of literally every cell in your body. Plus, it’s the original when it comes to flushing out toxins.

Make it a goal to drink a minimum of eight glasses of water a day, and if you’re still thirsty drink more. If you’re breastfeeding, chestfeeding, or

pumping breastmilk, you’ve probably felt that intensely parched feeling. The thirst that hits you when your baby latches is your body’s way of telling you to drink more water!

Cut Carbohydrates Bread, Bread, Bread! Oh, I tell you this can be challenging. Changing our habits to decrease carb consumption doesn’t happen overnight. But some carbs are good for you and making the switch from non-beneficial carbs to nutrientdense whole grains, brown rice, sweet potatoes, and veggies like zucchini squash is essential to losing weight.

Refined carbs such as grits, white bread, traditional pasta, and white rice increase insulin production, which can lead to increased weight. Of course, it’s important to get enough calories to fuel your energy, healing, and lactation, and you want those calories to really nourish you—refined carbs simply can’t do that.

Move it, Move it!

Moving your body is key to feeling strong, flexible, and energized, and it’s an important tool for trimming excess body fat. While recovering from childbirth, it’s important to take a slow and gentle approach to exercise.

Start with some gentle stretches to

soothe sore muscles, increase strength and flexibility, and brighten your mood.

Add a short daily walk with your baby and you’re off to a great start! Walking is a safe, low impact exercise, and even just 20 minutes three times a week can make a big difference.

Once you’re given the “all clear” by your pregnancy care provider, you can ramp things up a bit. Set yourself up for sustained success by starting off slow and then increasing the intensity of your workout as you build endurance.

Get Friendly You know that you are strong and that you can accomplish your goals but staying in it can be hard! Find yourself an accountability partner: Someone who cares about you and your journey, like your partner or another parent who’s trying to kick those pregnancy pounds.

Check-ins with friends make the journey more fun and reminds us of our worth along the way. Just like us, they want you to wake up each morning knowing how powerful you are. You got this!

Lakisa Ballard, MSN, RN, C-EFM, RNCOB, is a Clinical Practice Specialist who has worked in many high-risk pregnancy facilities throughout the US.

ISSUE 31 / 2021 Healthy Mom&Baby

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healthy moms

Boost Your Postpartum Nutrition Yes, you need more calories and supplements to help prevent nutritional deficiencies

By Carolyn Davis Cockey, MLS, LCCE

D

images: Dreamstime

uring the first weeks, postbirth experts at the CDC say it’s essential for postpartum moms to add in the extra calories and nutrients needed to support recovery and breastfeeding—and this runs, on average, approximately 330-400 calories a day.

If you consume a vegetarian or vegan diet, you may not get all of the nutrition you need to support lactation and nursing through food alone. Even if you’re eating a diet that includes all of the food groups, get most of those calories from nutrient dense fresh veggies, fruits, lean proteins and healthy fats, and avoid the temptation to hit the drive-thru on the way home from your postpartum appointments.

Along with good fresh food, you need adequate hydration.

Breastfeeding may dehydrate you, so drink water each time you nurse your baby or use your breast pump.

Prenatal or Postnatal Vitamins?

The American College of Gynecologists & Obstetricians (ACOG) recommends that you continue taking prenatal vitamins while breastfeeding. Even if you choose not to breastfeed

your baby, the doctors at ACOG recommend you continue your prenatal vitamin for at least 6 months to support your postpartum recovery.

Some companies are now making postpartum supplements. Experts are mixed on whether a specific postnatal supplement is needed as their ingredients are very similar to their prenatal counterparts.

Postpartum Supplements & Postpartum Depression According to statistics from the CDC, between 11-20% of women who give birth each year in the U.S. experience postpartum depression symptoms, which is the leading risk factor for maternal suicide and infanticide.

With nearly 4 million births annually, that’s almost 800,000 women with postpartum depression each year.

Researchers at the UT Southwestern Medical Center recommend Omega-3 fatty acids in the postpartum period from fish oils containing both DHA and EPA as a number of randomized controlled trials have shown that omega-3 fatty acids significantly helped with postpartum depression.

Researchers observed, though, that the greatest benefits were gained by postpartum people who took fish oil

supplements in addition to receiving therapy for depression.

Support Your Postpartum Recovery Here’s the shortlist most oftmentioned supplements for use postpartum—most of which you can find in your prenatal vitamin or in the new postnatal supplements: hh Vitamin D for its ability to strengthen your immune system; some research shows it reduces the risks of postpartum depression— and perhaps anxiety too hh Probiotics to restore your gut’s bacterial balance hh Iron to stave off low energy hh Iodine to support your thyroid and baby’s brain and nervous system; the National Institutes of Health recommends 200 mcg daily during postpartum hh Vitamin B12 to boost the nutritional content of your breast milk hh Choline for brain health, which can also be found in meat, eggs, fish and dairy Carolyn Davis Cockey, MLS, LCCE is the founding editor of Healthy Mom&Baby, senior director of Partnerships and Publications at AWHONN and a Lamaze-Certified Childbirth educator

ISSUE 31 / 2021 Healthy Mom&Baby

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COVID-19 Vaccinations Don’t Increase Miscarriage Risks

IMAGES: DREAMSTIME

Hey mama, go ahead and breathe that huge sigh of relief.

A new study published in The New England Journal of Medicine has found no link between COVID-19 vaccinations and an increased risk of first-trimester miscarriages. This is further evidence of the safety of COVID-19 vaccination during pregnancy.

To explore the potential risk, researchers analyzed national health registries in Norway to compare the proportion of vaccinated women who experienced a miscarriage during the first trimester and women who were still pregnant at the end of the first trimester.

“Our study found no evidence of an increased risk for early pregnancy loss after COVID-19 vaccination and adds to the findings from other reports supporting COVID-19 vaccination during pregnancy,” said Dr. Deshayne Fell, an associate professor in the School of Epidemiology and Public Health in the University of Ottawa’s Faculty of Medicine and a Scientist at the Children’s Hospital of Eastern Ontario (CHEO) Research Institute.

“The findings are reassuring for women who were vaccinated early in pregnancy and support the growing evidence that COVID-19 vaccination during pregnancy is safe.”

Furthermore, the study team didn’t see a difference or a relationship to the type of vaccine—whether a mom received Pfizer, Moderna or the AstraZeneca COVID-19 vaccine.

healthy

pregnancy

Does Cesarean Increase Depression Risks?

New university research from Michigan Medicine is linking cesarean surgery to increased risks for perinatal mood and anxiety disorders, especially in first-time moms who may have experienced mood disorders before pregnancy but who were considered low risk during pregnancy and who were not planning for a surgical birth.

“It’s critical to better understand how these mood disorders increase the likelihood of cesarean section deliveries, which we know have both short and long-term health consequences for both expecting moms and their babies,” said senior author Vanessa Dalton, MD, MPH, obstetrician gynecologist at University of Michigan Health Von Voigtlander Women’s Hospital.

“Our findings reinforce the importance of better identifying and treating perinatal depression and anxiety disorders in pregnant women,” Dalton said. The study is among the largest to document a link between predated mood and anxiety disorders and first-time cesarean.

ISSUE 31 / 2021 Healthy Mom&Baby

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healthy pregnancy

By Jamie Vincent, MSN, APRN-CNS, RNC-OB, C-EFM

B

reathing is arguably the most important thing you’ll do today.

And if you’re pregnant, a healthy set of lungs is critical to make sure your growing baby gets the oxygen they need, and also to help you breathe out the excess carbon dioxide that your baby needs to eliminate. You’re breathing for two, now!

Just like the rest of your body, your respiratory system goes through remarkable changes during pregnancy for this specialized air exchange. You may notice that your diaphragm (the muscle at the base of your lungs) rises up to make room for your expanding uterus, and your rib cage spreads out to the sides to allow you to breathe normally.

Even with these changes, it’s easy to be short of breath in pregnancy. You’ll likely also notice more nasal congestion caused by pregnancy hormones.

Allergies in Pregnancy If you’re pregnant and have seasonal allergies or asthma, you may be asking yourself a few questions:  How do allergies or asthma affect my pregnancy?  Will pregnancy make my allergies or asthma worse?  Is it safe to take allergy or asthma medications during pregnancy?

Controlling asthma and allergy symptoms is essential so that you and your baby get the oxygen you both need to prevent pregnancy complications.

Experts know that poorly controlled asthma can increase baby’s risk for birth

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defects of malformations, preterm birth, growth restriction (a too-small baby), and a longer hospital stay for baby.

Uncontrolled allergies or asthma can also increase your risk for developing high blood pressure (like pre-eclampsia), problems with the placenta, needing a cesarean surgery, and a longer hospital stay. Your provider may need to monitor you and your baby more closely during your pregnancy to make sure you are not developing any of these complications.

Common Allergy & Asthma Symptoms in Pregnancy Research shows how you experience allergies and asthma falls into three categories:  One-third of moms find their symptoms improve  One-third of moms say symptoms get worse  One-third of moms say the symptoms stay the same If your symptoms continue or get worse during pregnancy, continue to take your medication and avoid things that make your symptoms worse.

Be sure to review your medical history and all your medications with your healthcare provider so that you can work together to find the best treatment options for your allergies and asthma symptoms during pregnancy, so you can make an informed decision about your care.

JAMIE VINCENT, MSN, APRN-CNS, RNC-OB, C-EFM, is a nurse expert advisor to Healthy Mom&Baby.

Common Asthma Medications  Most prescribed asthma medication can and should be continued during pregnancy. Sometimes long-acting beta2-agonists may be needed if the short-acting medications don’t provide good control of asthma symptoms.  Short-acting beta2-agonists, like albuterol inhalers or inhaled corticosteroids, like Budesonide (which is considered first-line therapy for asthma in pregnancy) are safe in pregnancy.  There’s limited research on the use and safety of leukotriene modifiers like montelukast, zafirlukast, and zileuton in pregnancy. If you’re taking one of these, talk with your care provider to see if one of the other medications listed might work for you instead.

Common Allergy medications  Most over-the-counter antihistamines like chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), loratadine (Claritin), and cetirizine (Zyrtec) are safe in pregnancy.

Cromolyn and fluticasone (Flonase Allergy) nasal sprays are also safe in pregnancy.  However, the antihistamine fexofenadine (Allegra) shouldn’t be taken in pregnancy, and oral decongestants like pseudoephedrine (Sudafed) and phenylephrine should also be avoided.  Allergy shots aren’t usually started during pregnancy, but if you already receive them and feel that they’re helpful, you can continue to take them during pregnancy at the same dose you were receiving before becoming pregnant.

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Managing Allergies and Asthma during Pregnancy

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For pregnancy and parenting advice at your fingertips, on any digital device from phone to tablet to desktop, the Healthy Mom&Baby digital edition is your searchable, clickable, readable friend!

Read online at:

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healthy pregnancy

Doulas Speak Out—Helping Moms Reclaim Their Power During Birth and Beyond What makes Doula care so essential to improving labor and birth for both mom and baby?

S

tudies show that community doulas are increasingly more common and available to pregnant moms. They also may be the key to reducing racial disparities in birth and in solving our country’s maternal health crisis.

Communities where the number of doulas is increasing are seeing decreased deaths and harms among laboring and birthing women. What is it about doula care that leads to improved outcomes for birthing people and their babies?

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What are Doulas?

Doulas are non-clinical birth workers who provide physical, emotional, and educational support to people during pregnancy, labor, birth, and postbirth (postpartum) recovery. While they don’t do health assessments or provide health care, their work definitely improves health.

Research shows that support from a doula results in healthier babies, shorter labors, fewer cesarean surgeries, and more birthing people beginning and sustaining

By Essence Williams, MSN, BSN, RNC-MNN, CCB, LCCE

breastfeeding with their newborn. In fact, having a doula during labor and birth may even help you feel more satisfied with your birth experience!

Doulas as Advocates Doulas help pregnant people navigate the healthcare system.

Experts suggest that doulas can stop negative experiences in hospitals as they empower birthing people to advocate for themselves. This includes protecting them from the harmful effects of implicit bias and

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healthy pregnancy discrimination that many Black, Indigenous and People of Color (BIPOC) people experience during pregnancy, labor, and birth.

Doulas Speak Out Naima Black, Director of Community Doulas and Lactation Services at the Maternity Care Coalition (MCC) in Philadelphia, PA, is a full-spectrum doula and has been doing this work, as well as the work of activism and advocacy in maternal child health, for more than 20 years.

She summarizes her work as a doula: “Helping women reclaim their power, trust in their body, and understand their body and the profound experience of bringing life into the world and how life changing that can be…honoring people for who they are and what they bring, has been really remarkable to me,” said Black. “One of the most rewarding, memorable and transformational moments for me was creating the perinatal community doula program and training model.”

images: Dreamstime

Doulas Break Barriers to Better Care

Making a Difference One Birth at a Time Iyonia Guinyard became a certified perinatal community doula in July of 2020 through the doula certifying body called Uzazi Village. She was part of one of the first graduating classes of community doulas in New Jersey.

Guinyard is now an alumni member of Community Doulas of South Jersey, which was born from a grant awarded to the Southern New Jersey Perinatal Cooperative (SNJPC) in 2019. Guinyard continues to serve Black and Brown families in the Camden and Atlantic City area.

As a full spectrum doula, Guinyard also created her own private doula practice called Kind Comforting Births that serves those in Burlington and Mercer County, New Jersey. A mover and a shaker in the New Jersey community, Guinyard says doula work is her passion and her calling: “Educating our Black and Brown mamas is so important and teaching them that it’s not a privilege to have a doula, it’s their right.”

New Jersey was the first US state

to offer Medicaid reimbursement for doulas. As a result, doulas can accept Medicaid, which increases the number of people who can train to become doulas and earn a living wage supporting laboring people.

Medicaid reimbursement for doulas has transformed access to doula services—and outcomes—in underserved communities. When asked how doulas can advocate to decrease the high infant and maternal mortality rate among Black and Brown moms and babies, Guinyard says: “There is still a lot of work to do when it comes to improving maternal child health in Black and Brown communities. But by encouraging pregnant and birthing people and their families to advocate for themselves and reclaim their power before, during, and after birth, community doulas may just be the answer to bridging the gap between the medical profession and family-centered care. Community doulas are changing—and saving lives!”

Essence Williams, MSN, BSN, RNC-MNN, CCB, LCCE is a member of the Southern New Jersey Perinatal Cooperative (SNJPC)

Most doulas agree that the greatest barrier to doula services is cost.

Typically, doula support has only been available to birthing people with the private financial means to hire them. As a result, doula care in many communities has become a privilege reserved only for those who can afford to pay for those services.

Low-income people, including those in Black and Brown communities, tell experts that they want access to doula support during labor birth, but simply can’t afford it. As a result, some hospital healthcare systems are starting to add doulas to their staff.

Community doula services in urban settings, like MCC’s Perinatal Community Doula Program, are addressing these barriers head on and offering doula services in underserved communities for free.

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healthy pregnancy

How do I Fix a Decreased Sex Drive During or After Pregnancy?

By LaShea Haynes MEd, MSN, APRN, AGCNS-BC, RNC, C-EFM, and Jessica McNeil DNP, APRN, CNM, RNC-OB, C-EFM

I

t’s OK to enjoy romance and sexual relations with your partner while pregnant and after birth. But what if during these emotionally changing times your hormones seem to be all over the place? Here are a few simple principles to consider for reigniting your love life and keeping the flame shining bright.

Focus on Your Partner Can you remember a time when you felt so much desire for your

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partner? There are several phases to our sexual response. The first is the time excitement phase. Most of the time, this arousal starts with physical excitement or emotional/mental arousal.

Try sending racy text messages to your partner throughout the day to build excitement and arousal. It never hurts for both partners in the relationship to know they are loved and desired. That always helps to heat things up later.

Focus on Feeling Desirable Another important factor to consider during pregnancy and after the birth of your baby is that you need to physically “feel” sexy and attractive. Ensure your lingerie (or whatever nighttime or exciting attire you enjoy) compliments your beautiful body.

This is not the time to attempt to squeeze into the same nightie you wore at your smallest weight or body frame. Embrace your pregnancy

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healthy pregnancy weight and allow yourself to feel desirable. That starts with wearing something you can feel comfortable in.

If you have already given birth, remember it took 9 months to create your beautiful baby; your partner should not expect you to be the same size you were before your bundle of joy was born. So, buy something in your current size and in your favorite color, or maybe a new color you’ve never worn before. Who says sexy only comes in red?

REV UP THE ROMANCE

Once you’ve worked hard to create a romantic and intimate evening, here are few things to consider:

1

Scented candles with your favorite essential oil or fragrance—the more you can light can create a relaxing, stress free environment.

2

High quality vaginal lubricant can be helpful, especially if you’re nursing or really nervous about intercourse after childbirth. You can also use it to stimulate you and your partner before intercourse.

3 4

Music can create a mood—set the tunes to set the tone.

Pop a cork—a bottle of champagne or nice bottle of wine to help to put you or your partner in the mood. If you’re breastfeeding, ask your lactation consultant about alcohol during breastfeeding. If alcohol isn’t your thing, sparkling ciders can be just as fun!

IMAGES: DREAMSTIME

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Change positions—trying a new sexual position can be exciting for you and your partner and can provide increased comfort both during and after pregnancy. While pregnant, you may enjoy positions such as side-lying, being on all fours with your partner behind you or being on top of your partner. If you

find penetrative sex uncomfortable, you and your partner may enjoy oral sex and/or utilizing toys to enhance your sexual experiences.

6

Fixing Vaginal Dryness—during the postpartum period, many women experience vaginal dryness.

Consider using a vaginal moisturizer and/or lubricant if you experience vaginal dryness or irritation. You can also try slowly easing into missionary position to enhance comfort.

7

Play with toys—it is safe to use most toys during and after pregnancy, unless advised otherwise by your healthcare provider. General rules for safely using toys include:  Ensure toys are clean prior to use and make sure to clean them after each use  Make sure to only use toys and techniques that do not cause any pain or discomfort. Toys that may have previously been enjoyable may be uncomfortable to use during pregnancy or postpartum. If at any point you begin to experience discomfort, immediately stop using that toy, or use it in a different way  Never use the same toy for both anal and vaginal sex as this can introduce bacteria and cause infection  Never share toys, as this too can lead to infection

Focus on the Good Feelings Finally, in this initial phase of excitement, really get in touch with what makes you feel good, and make sure your partner is in tune to that as well. How about trying a hot shower together? Lathering each other up with soap and oils can be a terrific way to stir up your hormones, allowing you to feel refreshed and relaxed. And massages standing up can be just as relaxing and fun as massages in bed!

If you’re used to getting massages in the bedroom while lying down, trying one in the shower can add a bit of spontaneity to your routine.

The most important thing to remember is that your health and comfort are the main priority.

Outside of medical complications or your healthcare provider’s recommendations, pregnancy does not have to mean an end to an enjoyable sex life. Having a decreased sex drive can be more complicated for some people. If you don’t find the answers you’re looking for here, don’t hesitate to discuss this with your healthcare provider.

LASHEA HAYNES MED, MSN, APRN, AGCNSBC, RNC, C-EFM is Editor of Healthy Mom&Baby, and founder of Perinatal Potpourri, LLC Nurse Mentoring & Consulting, and as a staff nurse, she has a career that has spanned more than 25 years in pregnancy care.

JESSICA MCNEIL DNP, APRN, CNM, RNC-OB, C-EFM is a certified nurse midwife, an adjunct Professor at Baylor University, and an expert adviser to Healthy Mom&Baby.

ISSUE 31 / 2021 Healthy Mom&Baby

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healthy pregnancy

Placenta Problems

By Jamie Vincent, MSN, APRN-CNS, RNC-OB, C-EFM

images: Dreamstime

T

he placenta is an amazing and complex organ that your body makes to provide oxygen and nutrients to your baby and to eliminate carbon dioxide and waste from your baby’s blood.

The placenta grows as your baby grows and ages as your pregnancy progresses. Shortly after conception, the fertilized egg implants in the endometrial lining of your uterus.

The placenta forms at the point of implantation, and the umbilical cord connects the placenta to your

developing baby.

From the baby’s side of the placenta, the amniotic sac surrounds your baby in a safe and sterile environment filled with amniotic fluid.

After your baby is born, the placenta is usually delivered within 30 to 60 minutes.

While rare, placental abnormalities sometimes happen, and when they do, they can increase the risk of complications for you and for your baby. Here’s what you should know about warning signs, as well as what

to expect if you are diagnosed with any of these complications during your pregnancy.

A healthy pregnancy includes a healthy placenta. If your medical history includes risk factors for placental problems, discuss these with your healthcare provider during your preconception planning visit or at your first prenatal visit. Planning can help to reduce your risk and establish appropriate prenatal monitoring or testing to help you and your baby have the best possible outcome.

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Placenta Previa

Placental Insufficiency

What it is: Placenta previa is when the placenta implants partially or completely over the cervix (the opening of your uterus). It occurs in about 1 out of every 200 pregnancies.

What it is: If the placenta doesn’t develop properly or if there isn’t enough blood flow to the placenta, it might not be able to provide enough oxygen and nutrients to the baby.

Risk Factors: Carrying twins (or more!), a history of cesarean or other uterine surgery, or a history of curette procedure (like a D&C), smoking, and using cocaine all increase your risk of placenta previa.

What it means for you and your baby: Having placenta previa increases the risks of bleeding during pregnancy, preterm birth, and postpartum hemorrhage.

What you can do: Call your provider right away if you notice any vaginal bleeding. Sometimes the placenta will move up and away from the cervix over the course of the pregnancy, but if not, you will need a cesarean birth to keep both you and your baby safe.

Placenta Accreta, Increta and Percreta (Placenta Accreta Spectrum) What it is: The placenta normally implants into the endometrial lining on the inside of the uterus. With Placenta Accreta Spectrum, the placenta grows too deeply into the uterine lining and into the uterine muscle, often over an area of a previous uterine scar. Placenta percreta is the most severe form of this disorder, where areas of the placenta grow through the uterine muscle and possibly into other organs in the abdomen, such as the bladder.

Because of the abnormal implantation that happens with placenta accreta spectrum, the placenta is unable to detach from the uterine wall after birth of the baby.

What it means for you and your baby: With placenta accreta spectrum, there is an increased risk of preterm birth. If it is detected prenatally, it often requires a cesarean birth and planned hysterectomy to prevent severe hemorrhage.

Risk Factors: A history of cesarean section or other uterine surgery, a history of a procedure like a D&C (curette) and having placenta previa all increase the risk of placenta accreta spectrum. The more cesarean births you’ve had, the higher the risk. In a recent study, the rate of placenta accreta in the U.S. was noted to be 1 in 272 births.

What you can do: Work with your healthcare provider to develop a coordinated plan for delivery in a hospital capable of managing placenta accreta spectrum. The National Accreta Foundation has many resources available at https://preventaccreta.org/resources

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Risk Factors and Causes: This can be caused by maternal anemia, clotting disorders, poorly controlled diabetes, or high blood pressure. In addition, both smoking and recreational drug use can lead to placental insufficiency.

What it means for you and your baby: Placental insufficiency can cause birth defects, preterm birth, and growth restriction (a too-small baby).

What you can do: Pre-pregnancy planning, monitoring and management of chronic conditions, and prenatal care during pregnancy can all help reduce the risk for developing placental insufficiency. If it does occur, good prenatal care can help to identify it in its early stages to help keep your baby safe. Be sure to let your healthcare provider know if you don’t feel your baby moving as much as usual during the third trimester of pregnancy.

Placental Abruption (also known as Abruptio Placenta) What it is: Placental abruption is when the placenta separates from the uterus before the baby is born.

What it means for you and your baby: Sometimes only a small portion of the placenta separates prematurely and does not affect the normal functioning of the placenta.

However, it does increase your baby’s risk for preterm birth, growth restriction, and stillbirth. If you develop a partial placental abruption, it may require close monitoring (either in the hospital or with more frequent prenatal visits). If a large portion or the whole placenta separates prematurely, this is a true emergency and requires urgent or emergent cesarean birth to prevent life-threatening hemorrhage for both mother and baby.

Risk Factors: Abdominal trauma (falling or being hit in the stomach), high blood pressure, smoking, cocaine use, infection, preterm leaking of amniotic fluid, and being older than 40 all increase the risk for placental abruption.

What you can do: Call your healthcare provider right away if you develop warning signs, including persistent abdominal pain, cramping, or vaginal bleeding.

Jamie Vincent, MSN, APRN-CNS, RNC-OB, C-EFM, is an expert adviser to Healthy Mom&Baby at John Muir Health System in California.

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Dealing with Postpartum Urinary Incontinence: Help is here!

By Leah Fulker, PT, DPT

If you are experiencing bladder leaks during your journey into motherhood – you are not alone! As many as 40% of postpartum women report urinary incontinence within their first year of giving birth, 33% within the first 3 months. And if you had a vaginal delivery, you are twice as likely to have urinary incontinence than if you had a C-section!

Stress urinary incontinence, or SUI, is the unintentional loss of urine with physical exertion such as coughing, laughing, sneezing, exercising, etc., and is a common complaint in the pregnant and postpartum population.

Flyte by Pelvital is a new, at-home treatment option that is FDA approved for pelvic floor muscle strengthening in just 5 minutes a day, which has been found to help women with SUI in as little as 2-12 weeks!

Flyte delivers a mechanotherapy treatment while you perform a Kegel! This technology has been shown to amplify the effect of each Kegel contraction 39x more than Kegels alone! More power = faster results!

This active treatment approach helps to regain the loss of strength and tone in the pelvic floor muscles from pregnancy and delivery due to overstretching these muscles.

It’s time to regain your life free of bladder leaks! And enjoy your life as a mom without the worry of buying pads - only the worry of diapers for baby!

Learn more about Flyte, the pelvic floor and Kegels at flytetherapy.com.

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healthy pregnancy

Early Postpartum Exercise Start Your Recovery from Birth Safely and Effectively

By Aliah Thomas, RNC-OB

A

Strengthening Pelvic Floor Muscles

Abdominal Muscle Exercises

Your pelvic floor muscles form the base of your “core.” Stretching from your pubic bone in the front to your tailbone in the back, and to the sit bones on your right and left sides, these muscles work with your deep abdominal muscles and your back to support your spine and control pressure in your abdomen.

Over the course of your pregnancy, your pelvic floor muscles support the ever-increasing weight of your growing baby. Then during birth, these same muscles stretch to birth your baby. After all this work, if we don’t strengthen them again during postpartum, we’re at increased risk for many common pelvic floor problems, including loss of bladder or bowel control (incontinence) and either painful or less pleasurable sex.

Your abdominal muscles (abs) form a corset that stabilizes your pelvis and supports your back; they’re essential to maintaining proper posture.

In the same way that pregnancy stretches your pelvic floor muscles, your uterus, growing in size with your growing baby, pushes outward on the vertical abdominal muscles running down the middle of your stomach, making them longer and weaker.

Oftentimes, they will separate and pouch out. This condition is called diastasis recti and affects about 60% of women during pregnancy and postpartum.

Normally, your separated stomach muscles will go back to their prepregnancy size within 8 weeks. But when they don’t, you’re more likely to experience long-term back pain and have a harder time getting your prepregnancy figure back.

IMAGES: DREAMSTIME

ren’t our bodies amazing? We can make, birth, and feed a whole new person! And as such, it’s important to honor ourselves by investing in a full recovery and healing after birth so we can live our best lives with our growing families.

This means taking time to strengthen the pelvic floor and abdominal muscles (core) that have worked hard to support your growing baby. And the earlier you start, the better. While it’s important to wait until about 6 weeks before resuming any intense exercise regimen, here are a few exercises you can resume immediately after giving birth—after you’ve celebrated with lots of snuggles and a good meal, of course!

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healthy pregnancy

Pelvic floor exercises, previously known as “Kegels,” can strengthen the pelvic floor muscles around your bladder, vagina, and bottom. These exercises can reduce your risk of incontinence and help to assure that sex (after 6 weeks, of course!) feels satisfying again. Kegels can be done anywhere and anytime, while lying down, sitting, or standing.

1. Find a comfortable position. At first, it may be easier to start lying down.

2. Squeeze the muscles around your bottom as if you’re trying to hold in gas.

3. Squeeze the muscles around your vagina and bladder as if you’re trying to stop the flow of urine.

4. Aim to hold the squeeze for 10 seconds, rest for 10 seconds, and repeat up to 10 times. If this is difficult, perform short squeezes for 1 second, with a 1 second rest.

Repeat 10-15 times.

5. Don’t perform Kegel exercises with a full bladder.

Start gently, stay within your comfort zone, and work up to stronger exercises when you can. Try to do these exercises at least 3-4 times daily. In the beginning you may find it difficult to feel your pelvic floor muscles working. It can take a few weeks to build their strength back up. But stick with it and soon you’ll notice a difference and feel your pelvic floor muscles contracting and relaxing.

It can be challenging to remember to do pelvic floor exercises at first, so try to make them a part of your daily routine by prioritizing them the same way you prioritize brushing your teeth.

Make time while you’re in the car, resting in bed, watching TV, feeding or cuddling your baby, or any other times that work for you.

1. Lie down, sit, or stand. Keep your back flat.

2. Take a deep breath in, and on the exhale, pull your lower abdomen in towards your spine. Try not to bear down while you do this.

3. Hold for a count of 10, then gently release.

4. Repeat up to 10 times.

Gentle Abdominal Exercises

Once you feel ready, you can add other very low impact exercises, such as gentle yoga and short daily walks.

This can add to your overall sense of wellbeing while improving circulation and helping to stretch out all of the sore spots as you recover from childbirth.

In addition to these exercises, take care to practice good posture, support your lower back with a pillow while sitting, and support yourself with your arm when getting out of bed or off of the floor.

Need More Help? If you still notice a bulge in your stomach, leaking urine, or pain with sex at 8 weeks postbirth, reach out to your provider and ask if you might be a good candidate for pelvic floor physical therapy. You deserve to have an intact body that functions beautifully, especially after all the work you’ve put into bringing your gorgeous baby into the world!

These gentle abdominal exercises can reduce the size of the separation of your abdominal muscles to help your body bounce back more quickly and completely and reduce your risk of chronic back pain.

Once the gap in your abdominal muscles has closed and your pregnancy care provider gives you the “all clear” to resume more strenuous exercise, you can progress to more challenging workouts with crunches, sit-ups, planks, or Pilates.

Get Moving Early with Exercise, But Take it Slow

ALIAH THOMAS, RNC-OB, is a perinatal nurse who has worked in women’s health for her entire career. She also serves as a Facilitator in the Nurse Residency Program for new graduates at her hospital and is passionate about patient education and advocacy

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IMAGES: DREAMSTIME

Pelvic Floor Exercises

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Nobody likes to be rushed, especially babies.

Your baby needs at least a full 40 weeks of pregnancy to grow and develop. Inducing labor even a week or two early is associated with a host of risks, including prematurity, cesarean surgery, hemorrhage and infection.

Slow ! down Relax.

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While it may seem convenient for you or your health care provider, labor should only be induced for medical reasons.

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healthy pregnancy

Choosing Out of Hospital Birth with a Midwife

By Paris Maloof-Bury, CNM, RNC-OB, IBCLC

W

ith the COVID-19 pandemic, more moms are choosing to give birth at home or in free-standing birth centers. And for good reason! Fear of exposure to the Coronavirus and the desire to have the support people of their choosing around them are two leading reasons for this trend.

But as with every choice in pregnancy and birth, it’s important to consider the risks, benefits, and alternatives, and review the evidence to be sure you’re making an informed decision. If you’re considering an out-of-hospital birth, read on as we take a deep dive into birthing options.

Birth with a Midwife Most out-of-hospital births are attended by midwives, though some physicians also attend births outside of hospitals.

In the US, there are essentially three different types of midwives:

hh Certified Nurse-Midwives (CNMs) — are advanced practice registered nurses with at least a master’s degree, who must pass a national certification examination. They practice in every state, can prescribe medications, and can provide care in all birth settings (in fact, most CNMs work in hospitals). hh Certified Midwives (CMs) — also have graduate level education and must pass the same exams as CNMs but are not nurses. So far, only a few states recognize CMs as primary care providers and allow CMs to practice. hh Certified Professional Midwives (CPMs) — are experts in out-ofhospital birth. They don’t have prescriptive authority and aren’t recognized as primary care providers in all states; their training varies by state and by program.

Midwives typically provide good outcomes because of their increased emphasis on good prenatal care, and their personal attention throughout labor and birth.

Be sure to establish care with your midwife early in the pregnancy and keep all your appointments to fully take advantage of the benefits of midwifery care!

Birthplace: Home or Freestanding Birth Center When we talk about an out-of-hospital birth,

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we’re usually referring either to giving birth at home or in a freestanding birth center. The laws that govern where midwives can legally attend births vary from state to state. and you can find out which options are available in your state here https://mana.org/about-midwives/ state-by-state

Risks vs. Benefits Research shows midwifery care is associated with greater chances of a healthy vaginal birth, better rates of starting and sustaining breastfeeding, and higher patient satisfaction scores regardless of where the birth occurs.

Since most out-of-hospital births are attended by midwives, it’s no surprise that home birth and birth center birth outcomes have far lower cesarean birth rates than hospitals.

Still, it’s important to consider safety. Research shows that the rate of neonatal deaths is higher with home birth than with freestanding birth centers or hospitals (3.9 vs. 1.8 deaths per 1000 births). So, where is the tradeoff?

How to Choose a Birthplace Researchers in the Centers for Medicare and Medicaid Strong Start for Mothers and Newborns Initiative study discovered that in addition to an excellent safety profile, freestanding birth centers had the best outcomes overall for birth when compared with hospitals.

In general, freestanding birth centers and home births result in lower cesarean surgery rates, fewer preterm births, higher rates of satisfaction, lower costs, and no increase in risk for

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healthy pregnancy

moms or babies. The doctors of the American College of Obstetricians and Gynecologists agree and recommend hospitals and accredited birth centers as the safest place to birth.

However, the American College of Nurse Midwives suggest that “Home birth is best accomplished in an integrated, supportive system of safe, seamless care with respectful collaboration among all health care providers and institutions if a transfer of care from home to hospital becomes necessary.” This speaks to the fact that sometimes plans change and the birthing family may need to be transferred to the hospital.

images: Dreamstime

Transferring from Home to Hospital Research shows that approximately 12% of all planned out-of-hospital births will likely require transfer to the hospital for mom and baby, either during labor or shortly after. About 75% of these transfers happen for non-urgent reasons, such as pain management and labor augmentation (pitocin to help move labor along).

About 25% of these transfers are for an urgent reason, such as heavy

bleeding or fetal distress. It’s also worth mentioning that transfers are far more likely to happen with first-time mothers.

cervix when labor begins hh No active genital herpes when labor begins

Considering Cost

Some midwives can offer vaginal birth after cesarean (VBAC) in an out-ofhospital setting, but policies and laws vary from state to state. If you’ve had a cesarean section previously, you’ll want to discuss your options with your midwife.

Another important thing to consider when choosing where to give birth is the cost. While home birth and birth center birth do cost much less than hospital birth, insurance coverage varies significantly across the country. Not all private insurance companies’ contract with community-based midwives, and some providers do not accept Medicaid.

Is Your Pregnancy Low-Risk?

Birth center or home-based births are best when your pregnancy is low risk.

Your pregnancy can be considered low risk if you have: hh A single baby hh Baby is head down hh Labor begins between 37 and 42 weeks of pregnancy hh No serious medical conditions (heart disease, kidney disease, blood clotting disorders, type I diabetes, gestational diabetes managed with insulin, preeclampsia, or bleeding) hh Placenta is safely away from the

Take Time to Prepare for a Birth Center or Home Birth Part of planning for a home-based or birth center birth means taking the time to prepare! Families who plan to birth outside the hospital should take childbirth classes and expect to labor without an epidural.

Some midwives offer nitrous oxide, but most families use natural techniques to cope with labor, such as laboring in water or walking while laboring. Eat well, exercise daily, take your prenatal vitamins to start labor in the best health possible.

Paris Maloof-Bury, CNM, RNC-OB, IBCLC, is a certified nurse-midwife and lactation consultant at Sutter Health in Davis, CA, and associate editor of Healthy Mom&Baby.

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healthy pregnancy

Healing Sore Nipples Babies suck. And sometimes breastfeeding hurts.

By Paris Maloof-Bury, MSN, CNM, RNC-OB, IBCLC

J

images: Dreamstime

ust because breastfeeding is healthy and natural doesn’t mean that breastfeeding is easy—or painless!

Managing the pain and difficulty of those early days is essential to meeting your breastfeeding goals.

Here are my go-to tips when it comes to healing sore nipples.

If you have sore nipples, you’re not alone. And we have good advice to help you heal!

Latch After you birth baby, ask your nurses to help you get started with breastfeeding. Getting a good latch with baby is essential for healthy breastfeeding. If it seems challenging,

or seems painful, ask for additional help from a lactation consultant.

Once you’re back home with baby you can also find support at a local breastfeeding support group or La Leche League meeting.

Hygiene While you normally don’t need to use soap on your nipples (they’re selfcleaning, and soap tends to dry out the delicate skin), if you have damaged nipples, cleansing is essential for preventing an infection, like mastitis.

Use a mild soap, and wash your breasts in the shower or bath, or soak them in a bowl of clean, warm water. Finally, be sure to always wash your hands (or use

sanitizer) before touching your breasts, using your breast pump, or nursing your baby. Bacteria on your hands can get into cracked skin and increase your risk for infection.

Healing After breastfeeding, apply a little expressed milk on your nipples and areola (the darker ring around your nipple (colostrum is perfect for this!), then let your nipples air dry. Once dry, apply a thin layer of coconut oil. Let this all air dry before you put your bra back on so that your skin doesn’t stick to your clothing. Trust me, you don’t want to have to peel away your healing skin the next time you take your bra off! For

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healthy pregnancy cracked, sore, chaffed nipples, some women use lanolin or nipple bandages to support healing breast and nipple tissues.

Nipple shields Modern nipple shields are made of thin, soft silicone, and when used appropriately, can be a wonderful tool to help keep moms and babies nursing.

They add a layer of protection for badly damaged nipples. They can also help draw out and lengthen inverted or flat nipples. More than just a good tool for moms, nipple shields help preterm babies and babies with tongue tie nurse. If you think a nipple shield might be just what you need, ask your nurse or lactation consultant for assistance. It is important that the shield be applied appropriately for it to work well.

Need a break?

If breastfeeding is just too painful, it’s OK to take a break and pump and supplement your baby with your expressed milk while your nipples heal.

You may want to rest your nipples for a single feeding or for 24 hours or longer. Just be sure to pump every 2-3 hours around the clock so that you protect your milk supply and prevent engorgement.

MYTH BUSTING BREASTFEEDING “If you’re doing it right it shouldn’t hurt.”

This is a classic example of blaming the victim. True, when breastfeeding is going well, it’s comfortable for both mom and baby. In fact, it can even feel good! However, there are at least two people in this breastfeeding relationship: The lactating person and baby. Just because the person with the milk is doing it right, doesn’t mean baby is. Don’t blame yourself if breastfeeding hurts. Get some help!

“That latch looks good to me. Are you sure it hurts?”

Gah! Nobody can see what’s going on inside the baby’s mouth while they’re nursing. The baby’s lips might be flanged, and the mouth might be wide, but if the tongue isn’t positioned correctly or if they are using their gums to stay latched, it can still hurt. Speak up for yourself! If it hurts, say so!

“Breastfeeding is just painful.”

The truth is, breastfeeding can be painful for the first few weeks, until you and your baby both get good at this. There is a learning curve here, and the faster you and your baby master this new skill set, the faster the two of you can get on to enjoying your nursing relationship. And that is exactly what your nurses and lactation consultants are there for!

“It’s going to hurt until your nipples toughen up.”

Nipples do not “toughen up.”

They get longer. Sometimes there can be a latching pain that lasts about 10-20 seconds as babies stretch the nipple deeply into their mouths. In these cases, breastfeeding is only uncomfortable for those initial seconds, but then the rest of the nursing session feels fine. That “latching pain” doesn’t typically last for more than 2 or 3 weeks. Once your nipples permanently lengthen (or evert, in the case of flat and inverted nipples), the stretching sensation will be a thing of the past.

PARIS MALOOF-BURY, MSN, CNM, RNC-OB, IBCLC, is Associate Editor of Healthy Mom&Baby and a certified nurse-midwife in Northern California who loves helping parents grow their families with love, support, safety, and empowerment.

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IMAGES: DREAMSTIME

Finally, while it probably goes without saying, your nurses and lactation consultants are all eager to help you and your little one learn how to latch easily and comfortably. After you’ve taken your baby home, reach out to local breastfeeding support groups where you gave birth or at a La Leche League meeting. While breastfeeding is natural, it doesn’t always feel that way. It’s a learned skill that you will perfect with time. In the meanwhile, ask for help! You and your baby will be glad you did.

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Let Sleeping Babies Sleep!

Researchers at Brigham & Women’s Hospital are finding that newborns who get more sleep, and who wake up less at night, are more likely to maintain a normal weight.

Scientists have long thought that getting enough sleep at night is essential for staying healthy no matter your age. Now, for the first time, researchers have found this to be true for infants.

Not getting enough sleep leads to weight gain in adults, said study co-author Susan Redline, MD, MPH, senior physician in the Division of Sleep and Circadian Disorders at the Brigham, and “in this study, we found that not only shorter nighttime sleep, but more sleep awakenings, were associated with a higher likelihood of infants becoming overweight in the first six months of life.”

Redline and colleagues observed 298 newborns born at Massachusetts General Hospital between 2016 and 2018. They monitored their sleep patterns using ankle actigraphy watches

that measure activity and rest. They took data points after three nights of sleep and again at 1 month and 6 months.

Tracking each infant’s height and weight, newborns were deemed overweight if they measured at or above the 95th percentile on the World Health Organization’s growth charts.

Researchers found that just one additional hour of sleep correlated with a 26% decrease in an infants’ risk of being overweight. Also, those babies who slept more through the night had a lower risk of excess weight gain. What researchers don’t yet understand the “why,” they think that when babies sleep more, they are fed on a more regular basis.

“This study underscores the importance of healthy sleep at all ages,” said Redline. “Parents should consult their pediatricians on the best practices to promote healthy sleep, like keeping consistent sleep schedules, providing a dark and quiet space for sleeping, and avoiding having bottles in bed.”

images: Dreamstime

Hipster Baby Names for 2021 These names are new and trending upward. Here’s a baker’s dozen of the fastest rising, coolest baby names from The Bump: 1. Mila 6. Zion 11. Urban 2. Nova 7. Maeve 12. Aria 3. Kai 8. Mia 13. Scarlett 4. Aaliyah 9. Ivy 5. Braxton 10. Luca

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How To Bathe Your Premature Baby

By Carolyn Davis Cockey, MLS, LCCE

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hances are the nurse who helped you bathe your premature baby in the hospital taught you a few tips and techniques to gently care for a premature newborn. But now that you’re home, you’re struggling to remember every step. That’s why we’re here to remind you to relax; follow these 6 easy steps to a stress-free and relaxing bath both you and your baby will love each time.

Baby loves the smell of your skin and the feel of your touch. Bath time is always the perfect time to talk, sing and bond with baby as you gently massage and clean their limbs and body.

Babies don’t need frequent baths

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like older children and adults. And with a preemie baby, less can definitely be more because their skin is still developing and is very sensitive. It’s easy to use too much cleanser or to let them soak for just a bit too long.

Perhaps your nurse may have advised waiting at least a week for baby’s first immersion bath, and instead suggested sponge cleaning areas that need freshening until baby is a little older.

When and where your baby may still have vernix–that super sticky coating they were born with–let that remain and only cleanse any visible soil from the vernix. It will eventually wear off on its own; there’s no need to wash or

rub it off as it’s Mother Nature’s perfect barrier cream designed just for your little one.

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Be prepared

Just as you would gather supplies before making your favorite recipe, get your bath assembled in a warm environment.

Choose a warm room without drafts, such as your bathroom. Have all of your supplies, including extra towels, clothes and a safe place to wrap and dry your tiny baby ready. Turn off the phone and ask your partner or another person for an extra pair of hands to help . . . just in case.

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healthy babies Place baby’s bathtub on a firm surface and set your bathing articles away from baby’s reach. Items to have at the ready include: hh Stack of warm towels hh Soft wash cloth hh Cotton balls hh Gentle cleanser made for baby’s skin hh Cup for rinsing hh Container of warm rinse water hh Soft brush designed for babies (for cradle cap, if present) Prepare the after-bath area for drying by padding with extra clean towels. To warm your towels before the bath, toss them into the dryer on the “delicate” cycle for 5 minutes or so. (Never use a microwave or oven to warm towels or clothes.)

Grab a diaper or two, since bathing often stimulates babies to relax and let loose!

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Test the water

Your baby’s bath should be warmer than lukewarm, so that they don’t get chilled, but not hot. Baby’s body temperature is likely 98.6ºF, so aim for bath water that’s between 99ºF to 100ºF. Test the water with your elbow, rather than your hand, as our hands are used to warmer temperatures. Remember to fill a non-glass container, like a large plastic pitcher, with warm rinse water before you begin.

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If they don’t relax into the bath, they may be telling you that they’re not comfortable. Perhaps the water is too hot or cold, or you are cradling them at the wrong angle in the water, or that they don’t feel well. Not all babies love baths at first. Help keep baby warm by covering their torso with a warm washcloth and in time you may notice that baby begins to look forward to this ritual.

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Clean from top to bottom

Beginning with the eyes, wipe from the inner to the outer eye corners with cotton balls or a corner of a clean washcloth soaked and wringed of plain water. Then change cotton balls or rotate to another corner of the cloth. Avoid cross-contamination of any bacteria housed in one eye to the other as it’s easily transferred. With this in mind, also avoid back and forth swipes on the same eye.

Continue to wash the rest of their body with mild baby cleanser. (For boys with fresh circumcisions, sponge bathe only until your baby’s healthcare provider confirms the circumcision has healed.)

Pay extra attention to the neck folds and creases in baby’s arms and legs! Relish the rolls upon rolls of plump skin.

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Rinse!

Don’t be surprised if rinsing startles baby–even if you’re ever so gentle. Start with pouring warm water from the top of baby’s head to the back of their neck, avoiding pouring water across their face. Then move down baby’s body, gently rinsing as you go. As you lift baby from the water to rinse their legs and feet, prepare to move them to the stack of warm towels at the end of the bath.

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Pat dry

As baby rests as you gently pat their skin dry, sing, coo, and talk to baby. Teach baby that bath time is a time to relax and enjoy the interaction with you. Lay baby gently on Their back on the stack of warm towels and wrap Them up from head to toe.

While cocooned in towels, gently pat baby dry–never rub baby’s skin–especially preemie skin! As their skin dries, dress them in warm layers of clothes to help them remain warm following their bath. Now, it’s snuggle time!

CAROLYN DAVIS COCKEY, MLS, LCCE, is the founding editor of Healthy Mom&Baby, Senior Director of Partnerships & Publications at AWHONN, and a Lamaze-Certified Childbirth Educator.

Gently place baby in the water

Supporting your baby in the crook of your arm or with your hand on their back, gently immerse baby into the warm water up to their shoulders. You may want to place a folded towel into baby’s supportive bath to provide a soft place to rest on.

It’s OK if baby still has their umbilical cord, you can immerse it too unless baby’s healthcare provider has told you not to do so. Concentrate on supporting baby’s upper body and allow their lower torso to float freely.

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THE SMALL WONDER FOR YOUR LITTLE ONE LectroFan’s non-looping sound technology does not use recordings, the sounds are generated as you listen to them, so they are guaranteed to never loop. Non-looping sounds are essential for restful sleep, don’t be fooled by cheap imitations.

Children are particularly sensitive to sound loops.

The small size will make it an indispensable part of your go bag and it will play for more than a day on a single USB charge.

Adaptive Sound Technologies, Inc. was founded in 2008 and is the leading supplier of advanced sound machines and adaptive audio products.

The company’s mission, “Adapting audio to improve lives,” has been the driving force behind its innovation and product development.

www.soundofsleep.com/alpha-3 HELPS YOUR BABY OR TODDLER GET BETTER REST LectroFan Alpha plays soothing sounds that help mask distracting noise.

GUARANTEED NONLOOPING SOUNDS 7 unique relaxing sounds for baby and parents.

Includes 1 heart-beat, 2 fan sounds, pink noise, brown noise, and 2 ocean wave sounds.

NEVER NEEDS BATTERIES Built-in battery recharges with the included USB cable, or use any standard USB C cable. Each charge lasts up to 40 hours at normal volume.

TRAVEL FRIENDLY Portable sleep sounds with a clip for easy transport between nursery, stroller, and car seat. The built-in stand folds up for travel.

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ABCs of Safe Sleep should sleep by himself.

Alone - Baby No blankets, no pillows, no loveys, no people.

Back -

Baby should be placed on her back for every sleep for the first year of life.

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Baby should be placed in their crib (or bassinet or play yard) that meets federal safety standards for every sleep.

Safe Infant Sleep Safe sleep. Every sleep.

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15 Safe Sleep Tips for Baby Follow these recommendations from the American Academy of Pediatrics to keep your baby safe whenever and wherever baby’s sleeping

By Sharon C. Hitchcock, DNP, RN-C and Melanie Welch, MSN, RN

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Share your room—not your bed—with baby. Some babies are especially at risk when they share beds with others. This list includes babies who are less than 4 months old, babies born premature or of low birth weight, babies born to moms who smoked during pregnancy, bed-sharing with anyone who smokes or has taken sedating medications or alcohol, and bed-sharing with nonparent caregivers or siblings/other children. Sleeping with baby on a couch or recliner is dangerous.

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Breastfeeding is protective!

Giving baby only breastmilk for the first 6 months is best, but any amount of breastmilk helps protect against Sudden Infant Death Syndrome (SIDS). When feeding baby at night, an adult bed with no blankets or pillows is considered safer than on a couch or recliner.

4 Babies should sleep on their backs, starting from birth, every time they sleep. Swaddling is calming; make sure to do it properly. Don’t use wedges or positioners.

2 Keep all soft objects out of the crib or basinet, including blankets, pillows, bumper pads or stuffed toys. Dress baby in blanket sleepers or a swaddle sack for warmth.

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images: Dreamstime

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Use a firm sleep surface for baby in a safety-approved crib, bassinet or playard. Bedside or “sidecar” sleepers that are government safety-approved are an option.

Offer baby a pacifier—it’s protective against SIDS! Wait until breastfeeding is going well (3-4 weeks) to introduce the pacifier and don’t hang it around baby’s neck or attach it to clothes. No need to reinsert if it falls out.

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healthy babies Get regular prenatal care. Going to your visits means your baby will have a lower risk for SIDS.

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Don’t let baby routinely sleep in sitting and carrying devices such as car seats, strollers, swings, bouncers, carriers or slings. Babies under 4 months are especially at risk to suffocate in these situations.

Let baby breathe clean air. Smoke of any kind around baby in the house or car is a major risk for SIDS. This includes tobacco and marijuana smoked in cigarettes, cigars or vaped.

Immunizations are protective! Attend all well-baby checks and follow guidelines for baby’s vaccinations.

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11 8 Don’t expose baby to alcohol, marijuana or street drugs during pregnancy and after birth. The risk of SIDS increases when mom uses any of these during pregnancy or, after baby is born, if either parent is using and sleeping with baby.

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Provide lots of “tummy time” when baby is awake and supervised. This helps prevent flat spots on the head and promotes normal shoulder and neck development Avoid monitors or devices marketed to reduce the risk of SIDS—their claims may not be supported by evidence.

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Don’t overheat baby. Keep room temperature comfortable for an adult and don’t dress baby in more than one additional layer to what you’re wearing.

Don’t cover baby’s face or head for sleeping.

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Educate everyone who cares for baby about these safe sleep rules, including grandparents, relatives, babysitters, siblings and friends

images: Dreamstime

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Baby Belly Band Calm & soothe your fussy, gassy, colicky baby, naturally.

The MEMEENO band gives your baby just enough warmth & hug around the tummy to comfort the belly to help ease out gas & relieve aches. All bands are made from premium organic cotton, inner polyfleece layer & water-based dyes in all the beautiful prints.

A little hug & a lot of warmth is all you need!

Moms love MEMEENO “Works great for fussy baby with gas. I put it on my newborn when she hasn’t had a bowel movement and within an hour she’s ready! Best purchase and works wonders.”

-Krystle T., MEMEENO Mama

Snuggle. Soothe. Love.

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Teething 101 Teething can be trying, but you can help your baby comfortably welcome their chompers!

By Paris Maloof-Bury, MSN, CNM, RNC-OB, IBCLC

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eething usually begins between 3 and 12 months and continues into the third year. Get ready for the cutest little smile you’ve ever seen! As their teeth are pushing up through their gums, babies may seem more fussy than usual, have difficulty sleeping, gnaw on their little hands, or chew on their pacifier or bottle nipple.

Some babies will even run a lowgrade fever (less than 100.4 degrees Fahrenheit). Sometimes babies will seem less interested in nursing or drinking from their bottle because their gums hurt. In these cases, managing your baby’s teething pain is top priority.

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Teething: Protect Budding Teeth from Cavities It’s ok to nurse your baby to sleep!

Research has clearly demonstrated that naptime and bedtime nursing doesn’t cause cavities. And the American Dental Association recommends breastfeeding to support your baby’s dental health and development. But don’t let your baby fall asleep with a bottle of formula, milk, juice, or any other liquid (except water) once their first tooth comes in, as this can lead to cavities in your baby’s teeth.

Whether you’re breastfeeding, bottle feeding, feeding solids, or some

combination of all three, it’s important to clean your baby’s mouth regularly. A clean washcloth along the gums once a day is enough for babies without teeth.

Once your baby’s first tooth comes through use a small, soft-bristled toothbrush to brush your baby’s teeth twice a day.

Breastfeeding & Teeth The first two teeth to erupt are usually the lower front teeth, which make for a super cute smile! You may worry that breastfeeding will suddenly become painful when baby gets teeth. However, because the baby’s tongue covers the lower gums while nursing, those first two teeth don’t typically affect baby’s latch.

What about when those top teeth come in? Babies move their jaw while they’re nursing, not their mandible (where the top teeth are found). As long as baby has a wide latch, those top teeth should not interfere. Ideally, baby’s head should be tilted back

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healthy babies slightly while nursing, while their chest and chin should be close to your body.

You can help keep baby’s latch and position comfortable by supporting your baby firmly between their shoulder blades.

When your baby’s teeth come in, remember, this is new to both of you— you just need a little time to adjust.

My Baby Bites During Nursing!

Not all babies bite: It’s important to make this clear, because even the thought of those tiny teeth can intimidate the most devoted nursing person. It’s also worth noting that babies who are actively nursing can’t bite because while their tongue is busy drawing milk from the breast, it covers baby’s lower teeth and gums. But let’s be honest: Biting somehow happens.

Reasons Babies May Bite During Nursing When baby’s biting behavior is recurrent, not an isolated incident, pay attention to when biting happens –the

goal is to anticipate and stop it before it happens.

No Thank You: Does baby bite at the beginning of the nursing session when they first latch on? Baby probably wasn’t interested in nursing just then.

This baby might be more interested in exploring or playing right now. Solve this problem by waiting to breastfeed until your baby communicates that they’re hungry.

All Done! Does baby bite toward the end of the nursing session? Some babies begin to play (biting being one form of play and exploration) once they’ve finished nursing. If this sounds like your baby, your job will be to watch for signs that they are done nursing, and then unlatch pronto. You might notice that their suck slows down, that they stop swallowing, or that their position changes. If they’re not actively nursing anymore, unlatch them quickly.

Paris Maloof-Bury, MSN, CNM, RNC-OB, IBCLC, is Associate Editor of Healthy Mom&Baby and a certified nurse-midwife in Northern California who loves helping parents grow their families with love, support, safety, and empowerment.

Manage Teething Pain Cold Wash Cloths: Using a cold, clean wash cloth to wipe down baby’s gums does three things.

It helps keep baby’s mouth clean, which reduces bacteria and inflammation. It provides an opportunity to massage your baby’s gums directly. If you use a clean, frozen wash cloth (soak it in water first), the icy cold can bring quick relief to aching gums.

“Momsicles:” Use frozen breastmilk to soothe sore gums.

You can either freeze some in an ice cube tray, or break chunks off from what you have frozen in a milk storage bag. You can hold the frozen milk to your baby’s gums for them or let them do it themselves.

Mesh teething feeders make it easier for your baby to hold onto the frozen milk. Remember, once the milk has been defrosted, it must be used or discarded within 24 hours.

Jaw Massage: Massaging the skin and muscles on your baby’s jaw can help ease some of the tension built up from the grinding and clenching that happens when baby is teething.

Extra Snuggles: It’s normal for babies to be a little bit clingy when they are in pain. Teething babies often need to be held, soothed, and carried more than usual.

images: Dreamstime

Teething Toys: Teething toys can really come in handy! Some are even intended to be chilled in the refrigerator or freezer. Remember to clean them before each use to protect your baby from germs.

Cold Foods: If your teething tot is age six months+ and ready for solids, a frozen bagel, a whole raw carrot, or other suitable cold foods can work wonders. Put cut-up chunks of cold fruits and vegetables into a mesh teething feeder that your baby can hold onto and gnaw on themselves. Remember, babies should always be supervised when they are eating.

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To cut or not to cut?

The Circumcision Choice

By Michele Savin, DNP, MSN, NNP-BC

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f you’re pregnant and expecting a baby boy, you may be thinking about circumcision: what it is, why it is or isn’t done, and how to make the right choice for your baby.

Circumcision around the world Circumcision is the removal of the skin covering the top of the penis, which is called foreskin. Here in the US, routine infant circumcision is the most common surgical procedure in the newborn period; it’s usually done to prevent potential health problems down the road.

In recent years, the rate of circumcision has decreased, and now about 55%-65% of males in the US are circumcised each year. Worldwide about 30% of men are circumcised.

In Africa and the Middle East, circumcision is performed for religious or cultural reasons. Outside the US, very few boys are circumcised where it is not done for religious reasons, and boys in areas like Asia, Australia, Europe, and Central and South America are rarely circumcised.

Circumcision—How do I decide what’s right for my baby?

The American Academy of Pediatrics (AAP) says the benefits of circumcision outweigh risks, so any family may choose it. While some parents choose circumcision for religious or cultural reasons, most consider it a medical procedure done to reduce health risks.

Some choose circumcision so that their son’s genitals are like his father’s and will look like most other boys, too.

When parents choose to circumcise

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a healthy boy, it’s safe and easily tolerated when done with good pain control by an experienced provider.

Discuss this decision with your partner and understand the reasons you’re choosing this for your son, since circumcision can’t be undone.

Alternatively, parents who choose to keep their baby boy intact often do so because the foreskin plays an important role in keeping the glans (head of the penis) healthy and protecting the end of the tube where urine exits the body (urethra), just as external female genitalia does.

Never fear, it’s easy to clean an intact penis, and using condoms is far more effective than circumcision at

preventing HIV and other STDs. Some parents say that since the potential benefits of circumcision extend into adulthood, boys should have the right to wait and make their own decision.

Benefits of Circumcision Benefits of circumcision include: hh Decreased risk of urinary tract infection during infancy hh Decreased rates of some sexually transmitted infections hh The only medically necessary reasons for circumcision are problems with the urethra, such as epispadias or hypospadias; or foreskin, such as tightening of the skin (phimosis), frequent swelling of the penis head (balanitis), and skin cancer.

Risks of Circumcision

Circumcision Procedure There are three devices commonly used for newborn circumcision: XX Gomco clamp XX Mogen clamp XX Plastibell Topical medication may be used to help with pain; it’s better to ask your provider to use a pain block, or local anesthesia that’s injected into the penis. Parents are often present for the procedure.

Common early side effects are pain, bleeding, swelling and infection, which happens in about 3% of procedures.

Complications also include bleeding and local infection, followed by poor cosmetic results (too little or too much skin removed), or surgical trauma or injury. These outcomes may require additional surgery.

When to Circumcise Your Child Circumcision is safest during the newborn period. It’s important to wait to circumcise your baby boy until he’s healthy, has had time to recover from birth, and has urinated at least once.

Your baby’s provider should first examine your baby’s penis to make sure there are no abnormalities, e.g., hypospadias. If he’s sick, premature, or has bleeding problems, delay

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circumcision until he’s healthy. If your baby is more than 4 weeks old at the time of circumcision, ensure the procedure is done by a doctor who routinely does circumcision and uses general anesthesia.

Costs of Circumcision

images: Shutterstock; getty images

Depending on whether you have private or public health insurance, and where you live, the procedure typically costs between $300-$1,000. Most insurance plans cover circumcision but check with your individual provider prior to the procedure.

Caring for a Circumcised Penis Depending on the procedure, how you care for your son’s penis may vary slightly. Typically, the skin is removed with clamp techniques. With the plastibell device, a small plastic ring remains and will fall off with the foreskin a few days later.

After the procedure, acetaminophen may be needed for pain, but sometimes breastfeeding/chestfeeding or simple sugar are enough to soothe baby.

It‘s important to keep the area clean using plain water during diaper changes. Petroleum jelly can prevent the healing penis skin from sticking to diapers, causing pain, irritation, or bleeding. Call your baby’s pediatric provider if you see swelling, bleeding, or signs of infection, or if your baby stops urinating.

Caring for an Intact Penis If you choose not to circumcise, caring for your baby’s penis is easy. To clean, wipe the outside of the penis from the base to the tip during diaper changes and in the bath. Do not retract your baby’s foreskin, which is naturally fused to the glans and isn’t meant to retract until later in childhood. Premature retraction can cause pain, bleeding, infection, and scarring.

Care of an intact boy’s genitals is very much like that of a little girl’s genitals: Use plain water (soap can cause irritation), and just wash what’s on the outside. A good way to think about this is “when intact, don’t retract” or “only clean what can be seen.”

When his foreskin is ready to retract, he’ll do it himself—they always do!

When that time comes, he can clean the glans by retracting the foreskin in the shower or tub, rinsing with plain water, and then bringing the foreskin back to its forward position.

Whether or not to circumcise is one of the earliest decisions you’ll make for your son and it comes with both risks and benefits. As with any parenting choice, being informed will help you make the right decision.

Michele Savin, DNP, MSN, NNP-BC, is a Neonatal Intensive Care advanced practice nurse and an expert adviser to Healthy Mom&Baby.

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Infant Massage for Babies in the NICU

Your little one can benefit from your touch with these therapeutic massage tips— even if they’re in the neonatal intensive care unit!

By Britt Frisk Pados, PhD, RN, NNP-BC, CLC, FAHA, FNAP & Kelly McGlothen-Bell, PhD, RN, IBCLC

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hen babies are born prematurely or with complex medical conditions, they often need care in the neonatal intensive care unit (NICU). NICU care can be stressful for babies, in part because they’re separated from their parents, but also because some treatments can be painful.

Since all this stress can have negative effects on baby’s growth and development, neonatal nurses use therapies such as comfort sucking, skinto-skin care, kangaroo care, swaddling, positioning, and infant massage to help babies heal quickly and develop normally. Studies show that these soothing techniques—especially infant massage—are beneficial not only for babies, but for their parents too!

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Infant Massage History and Techniques Massage is an ancient therapeutic technique that was first documented in Chinese medical literature more than 4,000 years ago. Massage therapy is the use of therapeutic touch to stimulate the skin, muscles, bones, and joints, using techniques such as stroking, friction, stretching, compression, and the passive movement of joints.

Today, parents all over the world use infant massage as part of their daily bath and bedtime routine, and to enhance bonding.

Infant Massage in the NICU During pregnancy, your baby experiences constant gentle stimulation through contact with amniotic fluid

and the walls of your uterus, which is important to their development. But when babies are born prematurely, they miss out on this constant connection with you. Instead, touch is often limited to medically needed care, which can feel painful and stressful for the baby.

Infant massage provides your baby with the much-needed positive, comforting touch and helps reduce the physical separation between you and your precious baby. Neonatal nurses recognized the need for new therapies to reduce stress in their tiny patients and began studying massage therapy in the NICU in the 1980s. We now know that infant massage not only reduces stress, but it enhances neurodevelopment and speeds healing in babies!

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healthy babies Massage Benefit: Infant Weight Gain One of the most powerful benefits of infant massage can be measured in grams and ounces. A simple 15-minute massage three times a day has been shown to help preemies grow faster and stronger! Your baby’s nurse can teach you how to gently touch and massage your baby to help them meet those measurable milestones.

Massage Benefit: Shorter Hospital Stay When baby is in the NICU, the thing nurses want most is for them to get big enough, strong enough, and healthy enough to hurry home. But before baby is ready to leave the hospital, they must meet all of their goals, including learning how to nurse or feed from a bottle. Believe it or not, infant massage can help them master this skill, so they are ready graduate from the NICU sooner!

Massage Benefit: Brain Development

studies show that 40% of parents of NICU babies will struggle with postpartum depression. The good news is that studies have also found that infant massage can help improve those symptoms.

Touching, holding, and massaging your baby triggers the release of the feel-good “love hormone” oxytocin.

This hormone helps to relieve anxiety, sadness, and depression, and helps parents feel more confident in their ability to care for their babies. And parents say it feels good to know there is something that they can do to help their babies get better.

Ready to Learn?

Infant massage is easy to learn and good for both you and baby, and your baby’s nurse can teach you how and when it is safe to do! With a baby who is so tiny and fragile, you might feel a little intimidated, and that’s normal. The main things to remember are to use firm but gentle pressure.

Your baby’s nurse will teach you the kind of touch techniques that

are healing and therapeutic so that baby’s little tubes and wires don’t accidentally disconnect and so that your baby doesn’t get hurt. Try to practice mindfulness and stay mentally “present” during the massage.

If your baby is especially sick or unstable, it might be best to simply place and hold your steady hand on your baby. As with all things in the NICU, it’s important to watch for cues that your baby is ready, as well as subtle signs that they’ve had enough.

With time, you’ll be an expert on reading your baby’s cues and responding with just the right touch.

And even if they can’t tell you yet, your loving presence is exactly what your baby needs!

Britt Frisk Pados, PhD, RN, NNP-BC, CLC, FAHA, FNAP, is an assistant professor at the Connell School of Nursing. She is a certified neonatal nurse practitioner, lactation counselor, and trauma-informed professional.

Kelly McGlothen-Bell, PhD, RN, IBCLC, is a nurse scientist with extensive experience in health disparities research and a focus on parental engagement and neonatal feeding success in marginalized populations at the School of Nursing at UT Health San Antonio.

We’ve seen three different studies so far that have shown that infant massage improves baby’s brain development. Does this mean your baby will be smarter? Maybe!

Massage Benefit: Pain Relief

images: Dreamstime

While we wish it wasn’t so, some of the medically necessary steps we take to help babies survive and thrive can cause them pain. Things like IV starts, blood draws, and tape removal can be hard to handle. The good news is that research shows that infant massage can help to minimize pain during these procedures, which means there’s a lot YOU can do!

Massage Benefit: Infant Massage is good for Parents, too!

Having a baby in the NICU is really, really stressful for parents. In fact,

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How To Conquer Potty Training I t’s easy to get down in the dumps helping your kiddo conquer the commode, but this painstaking process is worth doing right. Experts including the American Academy of Pediatrics agree a positive, gentle approach is best. Follow this age-appropriate guide on how to conquer potty training and achieve potty success.

At 18 months Use the correct words for poop and pee and encourage your child to do the same. Change your child often and encourage him to come to you when he needs a fresh diaper. Avoid referring poop as “yucky”, rather, make diaper changes pleasant.

At 21 months Introduce a potty chair and toilet by transferring poop from dirty diapers into the toilet. Ask your toddler to sit on the potty chair while you read with or play games with him/her. Ask him/her to sit on their potty chair while you use the toilet or have him/her observe an older sibling using the toilet.

interruptions—during which time your child won’t wear any diapers, pull-ups, or underwear—nothing below the waist. This trial-and-error experiment could lead to a major breakthrough for your little one.

Tools of the Trade to Conquer Potty Training  Potty chair: Your child’s feet should touch the floor when seated.  Training pants: These introduce the idea of underwear while minimizing accidents.  Underwear: Let your wee one choose their underpants, and use underwear as a treat to encourage him.

Our guide on how to conquer potty training 101

By Carolyn Davis Cockey, MLS, LCCE

Do encourage with rewards like animal crackers or stickers—make a little chart to celebrate successes near the potty.

Don’t get frustrated—children will pick up on your feelings and may become overwhelmed. There’s no need to rush; it will happen with practice and determination.

CAROLYN DAVIS COCKEY, MLS, LCCE, is the founding editor of Healthy Mom&Baby, Senior Director of Partnerships & Publications at AWHONN, and a Lamaze-Certified Childbirth Educator.

Dos and Don’ts of Potty Training Do praise your child when she comes to you with a soiled diaper or in anticipation of needing a change.

Don’t discipline or punish your child if he has an accident. Say something like, “You’ll get the hang of this! You’re doing a great job!”

At 2 years

At 2+ years Once your child has successfully used the potty and understands the process, try what AAP calls “the bare-bottom weekend.” Commit to several hours with just you and your child—with no

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Let your child pretend to train a beloved teddy bear or baby doll to use the potty. Watch educational videos or read helpful books. Introduce wearing underwear as a privilege and put them somewhere visible. Start practice runs to the potty when you notice your child needs to go.

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Potty Training without the Mess Winner of the 2021 Mom’s Choice Award, Creative Child Magazine’s 2021, 2020 and 2019 Product of the Year Award in their Potty-Training Category; and nominee for the All Baby & Child 2018 New Product Award of Distinction in the Parent Helpers Category, the P-flector® was created by For Kids By Parents®, Inc.’s CEO, Joseph M. Conrad III, to solve the problem of his potty training son peeing through the gap between the toilet seat and bowl. For both parents, cleaning up the mess and changing their son’s clothes was very frustrating. The determination to solve this problem created the P-flector®.

for

The P-flector® attaches to the underside of both round and elongated

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by

Parents

toilet seats with pressure sensitive tape and blocks the gap between the seat and bowl, preventing seated kids from peeing through the gap. Once attached, the P-flector® can stay in place for extended periods of time.

While the tape is not permanent, additional tape is available to reapply it as needed. The P-flector® keeps clothes and floors dry, reducing the need for parents and caregivers to clean up the mess. Say goodbye to cleaning up urine puddles, yellow stains down the toilet’s front and yellow stained floors at the toilet’s base. The P-flector® is easy to attach, easy to clean, saves parents and caregivers time and avoids the frustration of cleaning up the mess associated with this type of pottytraining accident.

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The P-flector® and additional tape are both available on Amazon.com

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LECTROFAN

The LectroFan Alpha offers 7 unique non-looping sounds and a rechargeable battery lasting up to 40 hours per charge using the provided USB cable. It has a built in foldable stand and a clip to attach it wherever your child rests.

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HONED SUPPLEMENTS

Everyone’s health journey is unique - raising a young family it’s difficult to find a routine that works. Knowledge is power and finding confidence in your health is unlocked through personal insights. Finding supplements specific to your body’s needs improves your cellular metabolism and overall health. Don’t settle for not feeling like your best self!

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NUNA® CUDL™ BABY CARRIER

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Online Pilates program endorsed by obstetricians, safe for pregnant and postpartum women and designed by a Women’s Health Physical Therapist. Pilates workouts retrain core abdominals, tone abs, heal abdominal separations and pelvic floor. Also includes physical therapy advice, yoga, nutrition.

Nuna® CUDL™ makes it easy to keep baby close and secure, all while keeping your hands free.

Every position in CUDL offers your growing child ergonomic positioning to keep spine and hip development healthy.

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healthy babies

Enjoying the Fall Season

By Carolyn Davis Cockey, MLS, LCCE

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centers and events. On naturerocks.org you can also find destinations by type and events depending on the time you have available, proximity to your area and the age of your child to help you enjoy the fall season.

Get Outside

Shop Around

It doesn’t cost much money to enjoy the great outdoors (if any!) and it’s a great chance for your family to get fresh air and exercise. Go for a walk, apple picking, camping, jump in the leaves or get gardening. Not only does this help you be a healthy, close family, it also teaches your children about the natural world and other valuable life skills.

Studies show that children who play and explore outdoors are less stressed and may further benefit by learning confidence and social skills.

If you don’t know where to start, find a park near you at nps.gov, as well as family friendly nature trails, nature

Farmers’ markets are increasingly popular. Here you can buy locally grown, fresh produce and ask the farmer directly about his products.

Support your local farmers’ markets— they provide sustainable produce that helps preserve our environment by reducing transportation and packaging.

Enjoy a Saturday market stroll, sampling foods as you browse; this is a great opportunity for your kids to try new things. You may all be surprised to find that what’s delicious may also be healthy.

Then, with your loot in hand, pack it off to the park for a picnic, barbecue,

or tailgate party. There’s no better way to end the day than great food shared with friends in the great outdoors.

Build a strong family Many studies have shown that children who spend quality time with their parents are less prone to violence and substance abuse, not to mention the benefits to their language, behavior and emotional development.

Not everyone has the time to spare organizing elaborate days out or special activities, but simply scheduling a family dinner several times a week can make all the difference. And that is true for enjoying the fall season and the whole year round.

Carolyn Davis Cockey, MLS, LCCE, is the founding editor of Healthy Mom&Baby, Senior Director of Partnerships & Publications at AWHONN, and a Lamaze-Certified Childbirth Educator.

images: Dreamstime

all is a wonderful season to get into the great outdoors: It’s not too hot or cold and if you’re lucky to live where the trees change their leaves, you’re treated to a beautiful array of shades.

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Visitors & Your Baby During COVID

By Paris Maloof-Bury, MSN, CNM, RNC-OB, IBCLC

Keeping Baby Safe During COVID Even before COVID-19, the recommendation was to limit visitors and exposure for the first couple of months (at least until baby’s first round of vaccines).

Newborn immune systems are immature, so little babies are extra susceptible to all the germs. Babies with stuffy noses or ear infections have a harder time nursing, which can make life miserable for everyone. When babies have a hard time eating, the risk goes up for things like dehydration and jaundice.

And if there’s any sign of a fever, your healthcare provider will have to take every precaution to rule out a dangerous bacterial infection, which means blood draws at the very least. All of this can be extremely stressful, and better avoided in the first place.

During pandemic, apply the CDC’s general recommendations: hh Avoid indoor exposures to people not in your household hh Keep your baby at least 6 feet away from people not in your household hh If you take your baby outside of your home, insist that others wear a mask when less than 6 feet from baby

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Keep Social Activities Outdoors All visits should take place outside, where guests wear masks, and everyone remains socially distanced. Loved ones can still drop off meals and groceries and catch up on Zoom with older children.

For families who can’t follow these recommendations, try to limit the spread of infection: hh Limit visits indoors to no more than 15 minutes hh Ask visitors to maintain 6 feet of distance between them and your baby hh Ask everyone to wear a mask hh Ensure everyone washes their hands or uses hand sanitizer before touching baby

Restrict all visitors who: hh Have symptoms of illness (even mild symptoms) hh Have been exposed to someone who is ill hh Have been exposed to someone who is COVID+ There’s a silver lining for new families as moms and dads have discovered that sheltering in place with a newborn offers privacy, space to learn breastfeeding, and time to “sleep when baby sleeps.”

Paris Maloof-Bury, MSN, CNM, RNC-OB, IBCLC, is Associate Editor of Healthy Mom&Baby and a certified nurse-midwife in Northern California who loves helping parents grow their families with love, support, safety, and empowerment.

images: Dreamstime

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verybody wants to meet the new baby! There’s something so special about a fresh, squishy baby and the miracle of new life. Plus, family and friends are a source of wisdom, guidance, love, and support--not to mention help with household chores and meals! But during a pandemic, what’s the best way for parents to keep their newborn safe and healthy?

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cudl 4-in-1

The International Hip Dysplasia Institute acknowledges this baby carrier as a hip healthy product.

Keep them close Parenting can be intimidating—wearing a carrier shouldn’t be. CUDL™ 4-in-1 makes it easy to keep baby close and secure, all while keeping your hands free. Say hello to four magnetic buckles that make securing on-the-go quick and simple. And just like that you are ready in a snap.

It’s comfortable and customizable with breathable mesh fabric and padded shoulder and waist straps.

CUDL 4-in-1 offers your growing child ergonomic positioning to keep spine and hip development healthy.

Keep baby facing in and snuggled up starting with an integrated infant booster for newborns, which then easily unzips as your child grows.

CUDL 4-in-1 is designed so you can adjust and put it on alone, no helpers needed.

When baby wants to sightsee their world, have them face out or switch to back carry mode for growing toddlers.

Find out more at www.nunababy.com

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