ISSUE 18 / FALL 2015 | $3.95 | health4mom.org
PREGNANCY | BIRTH | PARENTING
Alcohol & Pregnancy CAN YOU REALLY
DRINK ’TIL IT ’S PINK?
PICTURE PERFECT REVEAL PARTIES
NEWBORN SKIN CARE ZONE
Everything You Need When Caring For Your Baby ’s Skin
EAT SMART BY TRIMESTER What is
GENTLE CESAREAN? FREE-RANGE PARENTING
BREASTFEEDING SUCCESS In 3 Simple Strategies
WIPE OUT DIAPER NEED POWERED BY THE NURSES OF
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Four Families Describe Their Diapering Struggles
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healthy babies 48 Babyproofing
Keeping your tike safe through age 2
Issue 18 / Fall 2015
51 Diaper to Prevent Diaper Rash
( CONTENTS )
The ABCDE ’s of healthy diapering
52 Alcohol Affected My Child
One mother ’s story of fetal alcohol syndrome
healthy moms
healthy pregnancy
12 Breastfeeding is Best
29 6 Strategies for Healthy Eating
15 Infertility Testing
pregnancy
17 Sleep More to Lose
Will you get to peek at your baby during
Prepare for the benefits to you and your baby
Here ’s when to seek help and what to expect
Weight
Could lack of sleep keep you hungry?
18 Drinking While
Conceiving
Find out how drinking affects fertility
20 Understand Parental Leave Does your state offer benefits in some way?
22 Creative Celebrations
From reveal to birthday parties; here ’s fun with a healthy twist
Here ’s how this registered dietician eats during
33 Understand Ultrasound pregnancy?
35 Your Blood Sugar Matters
54 Our Mission to Wipe Out Diaper Need
Families share their stories of how diaper need affected them in surprising ways
60 Filter Your Baby ’s Environment Make your baby ’s surrounding as green as possible
63 Tooth Or Consequences Can you raise a cavity-free child?
65 Free Range Parenting What ’s safe and at what age?
Understanding gestational diabetes and its risks
37 Third Trimester Changes Learn how your body prepares for birth
38 Gentle Cesarean
Free Range Parenting! p.65
Making surgical birth more family-centered
41 Breastfeeding Success Strategies
These 3 strategies will boost your breastfeeding
45 Dealing With Afterpains
Find out why you are still cramping post-baby
Wiping Out Diaper Need What would you do if you couldn ’t afford enough diapers for your youngest children? Four families share how diaper need affected their lives in surprising ways. Learn how you can join with Healthy Mom&Baby to wipe out diaper need and make sure every baby has all the dry and clean diapers they need to stay healthy.
54
Lacey Cott o has faced n the question: Do I spend my only $30 on ga s or diapers?
FEATURE
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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Bye bye, nasty cold symptoms. Bye bye. Getting a cold is a big deal for tiny bodies. No other company but Hyland’s offers safe and effective cold medicines that quickly provide natural relief to babies as young as 6 months.* We’re a happy discovery for thousands of parents, and have been for over 100 years. % ! % artificial flavors, dyes or parabens visit www.hylandsbaby.com Always read and follow label directions. * The uses for our products are based on traditional homeopathic practice. They have not been reviewed by the Food and Drug Administration.
O-Cal Prenatal vitamins for a healthy Mom and Baby Proper nutrition is the foundation for a healthy life and oftentimes we don’t eat correctly, which is why taking the correct prenatal vitamin daily is important. The Center for Disease Control urges women to take Folic Acid daily starting at least one month before getting pregnant. Folic Acid is very important in preventing major birth defects of the baby’s brain and spine (anencephaly ¹ĚÚ Ĺ¸ĹžÄœÄšÂą Ă†ÄœÄ€ Ú¹ťţ Â‰ÂąÄŠÄœÄšÄ? 8Ĺ…ÄŹÄœĂ? eĂ?ÄœĂš prior to conception may also reduce the risk of Autism by 40%. Iron and Folic Acid are two major nutrients that are crucial during pregnancy
for neurodevelopment of the baby. Studies show that mothers who take iron and Folic Acid during pregnancy have smarter babies. 80% of a newborn baby’s iron stores are accumulated in the 3rd trimester of pregnancy, thus it is very important that Mom not be iron ÚüĀ Ă?ÄœĂĽÄšĆ‹ĹŁ eßƋüų ĂšĂĽÄŹÄœĆ´ĂĽĹłĆźĂ˜ ƟŅƚ ĚüüÚ an adequate diet rich in essential nutrients such as calcium and Folic Acid to support nursing and replace depleted nutrient stores. :ĂĽĆ‹ Ĺ…Ă˝ Ć‹Ĺ… Âą Ä?ųü¹Ƌ ŸƋ¹ųƋ ĆľÄœĆ‹Ä˜ Ć‹Ä˜ĂĽ kÄ› ¹ď ĂźÂąÄľÄœÄŹĆź Ĺ…Ăź {ųüĚ¹Ƌ¹ď ¹ĚÚ aĆšÄŹĆ‹ÄœÄ›Ć´ÄœĆ‹ÂąÄľÄœÄšĹ¸ Ă´ Ć‹Ä˜ĂĽ üŸƋ }ĆšÂąÄŹÄœĆ‹Ćź ¹ĚÚ Ć‹Ä˜ĂĽ üŸƋ š¹ďƚüţ
Available at www.Pharmics.com or by calling 800-456-4138
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HEALTHY MOM&BABY EXPERT ADVISORY BOARD CANDACE ANN CAMPBELL, DNP, RN, CNL University of San Francisco Concord, CA ROBERTA DURHAM, RN, PhD California State University Eastbay Hayward, CA JOANNA GOLDBORT, MSN, PhD, RN Union Hospital Health Group Terre Haute, IN HELEN HURST, DNP, RNC, APRN-CNM University of Louisiana School of Nursing Lafayette, LA ELIZABETH JORDAN, DNSc, RNC University of South Florida College of Nursing Tampa, FL CAROLYN “CARRIE ” LEE, PhD, CNE, RN University of Toledo College of Nursing Toledo, OH JENNIFER LEMOINE, DNP, APRN, NNP-BC University of Louisiana at Lafayette Lafayette, LA CYNTHIA LORING, MS, RNC, CLC Brigham & Women ’s Hospital Boston, MA RITA NUTT, DNP, RN Salisbury University Salisbury, MD SUSAN PECK, MSN, APN Robert Wood Johnson Medical School New Brunswick, NJ MICHELE SAVIN, MSN, NNP-BC Christiana Care Health Services Wilmington, DE PAT SCHEANS, MSN, NNP Legacy Health System Portland, OR SHARON JEAN SCOTT, BSN, RN Mary Washington Hospital Fredericksburg, VA JAMIE M. VINCENT, RNC-OB, C-EFM, MSN, CNS John Muir Medical Center Walnut Creek, CA KIMBERLY WILSCHEK, RN, CCE Medical Revenue Solutions Chicago, IL
IMAGE © THINKS TOCK
CHARLOTTE WOOL, PhD, RN, CCNS York College of Pennsylvania York, PA
AWHONN ’s mission is to improve and promote the health of women and babies. Healthy Mom&Baby is powered by the nurses of AWHONN.
BY K AREN T. HARRIS, MSN, RN, WHNP-BC
Breastfeeding:
You, Your Baby and Your Nurses
Do you ever worry as do many expectant moms do that you may not be able to breastfeed your baby? Make enough milk? Know that you’re baby’s hunger is being met with your breastmilk? These are some of the common worries first-time pregnant moms have when it comes to how they will feed their newborn. Turn your worries into information, action and success with breastfeeding when you partner with your nurses before and after baby’s birth. Most mothers (79%) in the U.S. start breastfeeding in the hours and days after baby’s birth, yet only about 19% of infants are breastfed exclusively during the first 6 months of life despite the recommendations of experts at the World Health Organization and the American Academy of Pediatrics. This means 4 out of 5 babies are not consuming only breastmilk in their first 6 months of life, despite the proven short- and long-term health benefits. Research shows that if you get support and education from nurses and other nursing moms prior to beginning breastfeeding, you’re more likely to start, continue and breastfeed your baby longer than moms who didn’t get those same resources and support. Prepare for Breastfeeding during Pregnancy Breastfeeding is a relationship you begin with baby that creates a lifetime bond, and it starts with your commitment to breastfeeding during pregnancy. Your nurses are there to provide education, information, tips, connect you to support groups and help you and baby begin this journey together in the best possible way. To get you started, the mother/baby nurses of AWHONN, which publishes Healthy Mom&Baby, have prepared 2 new videos and Parent Pages on beginning breastfeeding designed you help you prepare and begin breastfeeding your baby. You can find these online at bit.ly/startnursing.
CONSUMER ADVISORS
Count On Your Nurses to Guide and Support Your Breastfeeding Start breastfeeding right after baby’s birth and you and your baby will have the greatest likelihood of sharing the special bond of nursing for as long as you both desire. Your nurses will be with you all of the way, eager and ready with research-proven information and expert care that will help you and your baby get off to the best possible start with nursing.
MARIA OPLT Lafayette, LA
KAREN T. HARRIS, MSN, RN, WHNP-BC, is the AWHONN 2015 President.
TAMERA YOUNG, RN, MSN Central Ohio Technical College Zanesville, OH
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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Advertorial
Guidance For Your Breastfeeding Journey Breastfeeding is one of the many new activities you’re likely to begin in [OL ÄYZ[ KH`Z VM `V\Y IHI`»Z SPML 0TWVY[HU[ [V Z[HY[PUN IYLHZ[MLLKPUN PZ [OL Z\WWVY[ HUK JV\UZLS [OH[ `V\ YLJLP]L HSVUN `V\Y IYLHZ[MLLKPUN QV\YUL` ;OHURM\SS` [OLYL HYL THU` [PWZ LX\PWTLU[ HUK ZLY]PJLZ [OH[ HYL H]HPSHISL [V OLSW `V\ Z[HY[ HUK JVU[PU\L IYLHZ[MLLKPUN BREASTFEEDING TIPS More Comfort, More Milk – Did you know that pumping is easier when you are relaxed and comfortable? Set up a “mom cave” filled with comfy pillows, a supportive armchair, glasses of water and snacks where you can retreat and nurse or express milk for baby. In the Zone – When you are breastfeeding or pumping, it’s tempting to multitask on your cell phone or do work. However, if you are having trouble expressing breastmilk, it’s helpful to stay focused on your baby. Even if you are expressing away from your little one, having photos or videos of your baby is a great way to stay relaxed and stimulate milk flow.
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Pump It Up! – Every mom deserves an effective, comfortable breast pump. When considering your purchase, keep an eye out for one like the Philips Avent Comfort Breast Pump which allows you to express breastmilk while sitting upright – rather than needing to lean over. Other details to consider include soft, silicone breast shields and customizable settings for more comfortable sessions. Hi Ho, Hi Ho! – You can continue feeding baby breastmilk when you head back to work. Before you return to the office, speak with your employer about its policies for accommodating breastfeeding, such as break time and a private space to express milk.
19/11/2015 12:21
Advertorial
Many moms often have questions or specific needs as they embark on their breastfeeding journey. The following tips will help you better understand the support, services and equipment that you may be eligible for through your insurance provider, under the Affordable Care Act (ACA) or through your state. There are differences in insurance coverage, so check with your insurance provider to understand your benefits. Did You Know: Breastfeeding services are one of many preventative care offerings moms may have access to. In addition to well-woman visits, health screenings and immunizations, many healthcare providers now offer breastfeeding support, supplies and counseling without “cost-sharing.” This means that private insurance plans must cover these costs without copayment, coinsurance or deductibles, although other restrictions may apply. If you do not have private insurance, you may still be eligible to receive breastfeeding services under your state’s Medicaid plan or through your local Women, Infant, and Children’s Office.
weigh each option in terms of size, portability, customizable suction modes, ability to express into bottles as well as warranties and recommendations. Setting Up for Success: Breastfeeding is not always easy or instinctual. In fact, it is a learned skill for most new mothers and support is helpful in order to have a successful transition. Luckily, more breastfeeding support and counseling services are now available in different settings including the hospital, in a clinic or at your home. Contact your insurance provider to find services near you. We’re here to help and guide you throughout your breastfeeding journey. To learn more about breastfeeding techniques and supplies, visit Philips.com/Avent or Health4Mom.org/breastfeeding.
I Choose You!: There are many different types of breast pumps so ask your insurance provider for their list of breast pump options. Then, work with your healthcare provider to 1 National Women’s Law Center. 2014. New benefits for breastfeeding moms: Facts and tools to understand your coverage under the health care law. Retrieved on September 1, 2015 from http://www. nwlc.org/sites/default/files/pdfs/final_nwlcbreastfeedingtoolkit2014_edit.pdf. Page 1-2. 2 National Women’s Law Center. 2014. New benefits for breastfeeding moms: Facts and tools to understand your coverage under the health care law. Retrieved on September 1, 2015 from http://www. nwlc.org/sites/default/files/pdfs/final_nwlcbreastfeedingtoolkit2014_edit.pdf. Page 1-2.
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What Can You Do to Help Babies?
Summer Hunt
Printed in the United States on paper made with 30% post-consumer recycled fiber. Please recycle this magazine! Healthy Mom&Baby is published by Maitland Warne in partnership with AWHONN. © AWHONN, 2015. All rights reserved. All material in Healthy Mom&Baby is wholly copyright. Reproduction without the written permission of the publisher 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.
Have you ever struggled to pay the rent and utilities and sacrif iced other essentials to do so, like clothing or enough diapers? The ongoing Healthy Mom&Baby Wipe Out Diaper Need drive at DiaperDrive.org joins nurses with families throughout the country to help families in communities like yours. Nurses are on the frontlines of care for women and infants and of ten see and respond to the needs of the most vulnerable patients — babies and their families — in their own communities by donating diapers to local diaper banks. You can do the same too for babies at DiaperDrive.org. In this issue, you ’ll meet Lacey Cotton, who shares the real struggles of hard working families and how they ’re af fected by not having enough diapers for their littlest ones. You ’ll be inspired by Portland mom Rachel Alston, who created a diaper bank in her community af ter needing help with diapers but f inding no resources when her daughter was born. “I don ’t think I truly understood diaper need until I experienced it myself, ” she says. Their experiences remind us that there are no federal or state programs that assist with diapers; and you can ’t buy diapers with food stamps or other public assistance funds. As you care for yourself, and your baby, what you can do to care for others? Donate time at a local diaper bank? Buy diapers and drop them of f at a women ’s and infant ’s shelter or health center? Give f inancially at DiaperDrive.org to buy diapers at wholesale through the National Diaper Bank Network? Please join with nurses in your community today to make a dif ference for babies everywhere. Until next time, baby giggles and smiles,
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Carolyn Davis Cockey, MLS Editor & AWHONN Director of Publications Health4Mom@AWHONN.org
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Moms
The Great Plate Debate BY SUMMER HUNT
Pyramids aren ’t always practical – that has never been truer than when it comes to your plate. ChooseMyPlate.gov is now being updated by the USDA with new recommendations to update your plate to give you a more plantbased diet, including veggies and fruit, paired with whole grains and smaller portions of proteins, especially animal proteins. Swap out regular milk for low-fat or fat-free, and replace sugary beverages with water instead. Dietary Guidelines are updated every 5 years —meaning we ’ll have a new set by the end of 2015. Preliminary reports suggest that we ’ll see the following: B Limits on sugar intake —a first for guidelines B Eating fewer red and processed meats —even lean meats B Cutting back on caffeine for pregnant women —previously unaddressed B Sustainability and the environment — a diet higher in plant-based foods and lower in meat
Is Your State Fertility Friendly? 1 in 8
couples have trouble getting pregnant
MAMMOGRAM? YES, MA ’AM! Early detection is key when it comes to breast cancer. According to breastcancer.org, mammograms have been shown to lower the risk of dying from breast cancer by 35% in women over 50. And when breast cancer is caught early, many women are able to avoid breast removal (mastectomy). All women should be going for an annual screening at age 40, say expert organizations. If you ’re at a higher risk, talk to your healthcare provider about sooner screenings.
RESOLVE: The National Infertility Association has launched The Fertility Scorecard, its updated index to measure and grade states ’ “fertility friendliness. ” Infertility is defined as the inability to conceive after 1 year of unprotected intercourse (6 months if a woman is age 35+) or the inability to carry a pregnancy to live birth.Here are the states with the best and worst marks: How does your state fare? Check out the complete scorecard map at familybuilding.resolve.org/fertility-scorecard.
IMAGES © 123RF
G R A DE A Connecticut Illinois Maryland Massachusetts New Jersey
G R A DE F Alaska Mississippi Missouri Oklahoma Wyoming
KNOW BEFORE YOU GO X Bring any past files or results with you. X Wear a skirt or pants, since you ’ll need to remove your top. X Don ’t apply deodorant or antiperspirant, as they interfere with the test. X Discuss your family history with your care provider.
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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healthy moms BY DRS. MICHAEL ROIZEN & MEHMET OZ
Breastfeeding is Healthy Best for Junior & You!
GET READY TO MAKE MILK The most important thing to remember about breast feeding is that not only are you passing along all the nutrients your child needs but also some others that he may not need or want courtesy of the foods and drinks that you ’re consuming. So, it ’s essential to get your own nutritional house in order. For optimum nutrition, keep taking your prenatal vitamin and make sure to get enough of the following nutrients —these are especially beneficial for your baby ’s health as they increase the quality of your breast milk: PROTEIN: 2 or 3 servings a day of beans, organically fed poultry (skinless), seafood (non-bottom-feeders or small fish; think wild—including canned—salmon, trout, mahi mahi), eggs, low-fat dairy, or soy. Fish protein is super healthy, but limit seafood to about 2 or 3 servings a week to avoid potential overconsumption of mercury and other trace elements. Salmon and trout are great sources of the omega-3 fatty acid DHA, as well.
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IRON: 20 mg a day from poultry, seafood, dried beans and fruit, egg yolks. Your multivitamin often includes more than that, and that’s okay while you are pregnant, breastfeeding, or menstruating.
VITAMIN C: 800 mg a day from citrus fruits, red peppers, broccoli.
DHA: 600 mg a day. An algae source, available in most drugstores, is ideal since it avoids any toxin concerns and is very palatable in pill form.
IMAGES: 123RF, THINKSTOCK
Your body knows exactly what your baby needs and puts together the best possible cocktail in the form of breastmilk, which contains protein, healthy fat, sugar, vitamins, and minerals plus some protective immune fighters. What might be most amazing is that the composition of your breastmilk actually changes as your baby grows, adapting to her changing needs. So if your baby needs more of the fat (DHA) that’s essential for brain development, more DHA appears in your breast milk. This is an important reason to continue your prenatal multivitamin during parenting and breastfeeding. From mid-pregnancy on, your body begins to make colostrum, a yellow, creamy “premilk” that’s full of proteins, vitamins, minerals, and infection-fighting antibodies. Colostrum is enough to nourish your newborn for the first few days after birth. When your milk comes in, your breasts may initially produce far more than your baby needs or can handle. As your hormones adjust and your baby establishes an eating pattern, you’ll produce almost exactly the amount of milk your child needs.
CALCIUM: 1,300 mg a day from supplements and low-fat dairy products, calcium-fortified orange juice, soy milk, tofu, broccoli, spinach, sardines, beans, sesame seeds, or oranges. It’s useless to consume more than 600 mg in any 2-hour period as that’s the maximum your body can absorb at a time, either from food or from a supplement. If you choose pills, we recommend that you take no more than 600 mg a day from supplements, and do chose a supplement containing calcium citrate, vitamin D3, and magnesium. The magnesium (onethird the dose of the calcium) is needed to prevent constipation or bloating from the calcium. Skip calcium supplements if you have kidney problems.
health4mom.org
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IS BABY GETTING ENOUGH?
While you can’t see what’s in your breast milk or typically measure how much is coming out while baby is nursing, you can get a pretty good idea whether it’s doing the job. Some women produce enough milk for quintuplets, while others question if they’re producing enough. All babies lose weight in the first week of life and then rebound to their birth weight by 2 weeks. Babies should double their birth weight by 6 months, and triple it by 12 months. If your baby is gaining weight appropriately and soiling diapers often, then you’re most likely giving him enough of the foods he needs. If he’s not gaining weight, talk with his healthcare provider about possible feeding problems.
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healthy moms
BENEFITS FROM BREASTFEEDING
For Baby
1.
MORE BONDING
Skin-to-skin contact from birth on during breastfeeding stimulates the release of oxytocin, a hormone that facilitates bonding.
2.
BETTER BRAINS Breastmilk builds better brains. Breastfeeding is linked to higher IQ scores in later childhood in most such studies.
3.
LESS DIARRHEA Breastmilk promotes higher quality bacteria in baby ’s gut and poop, reducing diarrhea and baby ’s chances of becoming obese or ever having type 2 diabetes.
4.
FEWER INFECTIONS Breast milk gives baby antibodies that he cannot make in any other way. These antibodies fight off viruses and bacteria that cause illness long before your baby can be fully immunized and make those antibodies for himself.
5.
REDUCED SIDS RISK Breastfed babies have a reduced risk of SIDS (Sudden Infant Death Syndrome).
For Mom
6.
LOWER RISK OF CANCER AND OSTEOPOROSIS Breastfeeding lowers your risk of breast and ovarian cancer by about 20% each. Some studies are also showing it reduces your risk of bone thinning (osteopenia and osteoporosis) and even hip fracture later in life.
7.
MICHAEL F. ROIZEN, MD, is a professor of internal medicine and anesthesiology, Chief Wellness Officer, and Chair of the Wellness Institute at the Cleveland Clinic. MEHMET C. OZ, MD, is a professor and vice chairman of surgery, as well as director of the Cardiovascular Institute and Integrated Medical Center, at New York ’s Presbyterian-Columbia University.
FASTER WEIGHT LOSS If the first 6 reasons aren ’t enough to convince you to breastfeed your baby, consider that you burn an extra 500 calories a day when nursing. This could cause as much as a 1 pound loss a week while nursing.
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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Share a voice, a song, a memory all before they’re born.
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healthy moms
Infertility Testing THE BASICS
BY TAMER A NUT TER, RN, MSN
TYPICAL FERTILITY TESTS
For men:
X Semen evaluation to determine the number, shape and movement of sperm X Blood testing for hormone levels including testosterone X Urological evaluation including a physical exam for genitalia evaluation
For women:
Infertility is diagnosed when a couple has tried, without any barriers, to conceive for a year without a resulting viable pregnancy. Many couples will find themselves unable to achieve a planned pregnancy, and about 1 in 6 women who are trying to achieve pregnancy with their partner can’t get or stay pregnant. If this describes the scenario between you and your partner, it’s time to talk to your healthcare provider or a fertility specialist about infertility testing. Infertility issues are found equally among men as women. TREATING INFERTILITY The most common infertility treatments for men are medications to correct hormonal issues and surgery to correct anatomical problems. Among women, infertility treatments can also include medications to correct hormonal problems, and surgery for any physical issues. Often, neither partner is determined to have an identifiable infertility problem. In these circumstances, most fertility specialists advise beginning with the easiest approaches to conception and advance to the more invasive procedures. If those efforts fail, assisted reproductive technologies (ART) can be considered, including artificial insemination and in-vitro fertilization (IVF). Here are the basic issues and tests you could expect as you strive to conceive:
B
COMMON INFERTILITY PROBLEMS
X
X X X
For men:
Problems that affect the movement or number of sperm, including varicocele
For women:
Issues with ovulation, including polycystic ovarian syndrome (PCOS) Blocked fallopian tubes Uterine abnormalities, including fibroids
B
WHEN TO CONSIDER INFERTILITY TESTING X For either partner through their early 30s after 1 year of actively trying to conceive, without contraceptive use and with no pregnancy achieved X For either partner in their mid-30s and older after 6 months of actively trying to conceive, without contraceptive use and with no pregnancy achieved X For either partner when there are known medical issues that may affect fertility
X Ovulation testing: Typically urine or blood tests to determine if ovulation is occurring, if the different phases of menstruation are optimal for conception, and if hormone levels are within normal range. Your ovarian reserve —the quantity and quality of your eggs —may also be checked early in your cycle X Endometrial biopsy: A small sample of the uterine lining is collected to assess if it can support a pregnancy X Hysterosalpingogram: This involves inserting dye through the cervix and then x-rays to check the if the fallopian tubes are blocked or open, and the shape of the uterus is also checked X Hysteroscopy: Insertion of a small camera through the cervix to examine the uterus for any abnormalities X Laparoscopy: Surgical procedure to examine the pelvis, looking for problems such as endometriosis or adhesions
TAMERA NUTTER, RN, MSN, is an expert advisor to Healthy Mom&Baby.
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Get the facts on preterm birth Did you know that one of the most important ways you can care for your new arrival is by staying pregnant until full term, or 40 weeks? That’s because babies born too early or preterm—delivery before 37 weeks of pregnancy— may miss out on important growth and development that happens in the final weeks of pregnancy.
What is preterm birth?
Preterm birth is the delivery of a baby too early—before 37 weeks of pregnancy—or 3 weeks prior to the due date.
What kind of growth takes place in the final weeks of pregnancy?
Important types of development that occur during the last few weeks of pregnancy include:
Lungs
Hearing
Liver maturity, includes the ability to prevent jaundice
Body fat to keep temperature steady
Breathing, sucking, and swallowing reflexes
Who is at risk for preterm birth?
Preterm birth can happen to any pregnant woman. For example, women who’ve already delivered a baby too early (before 37 weeks)—whether or not the baby had health issues—are at a higher risk for having another preterm birth. Certain factors may put some women at greater risk than others Leading risk factors include: • Prior spontaneous (unexpected) preterm birth before 37 weeks • Pregnant with twins, triplets, or other multiples • Problems with the uterus or cervix • African American heritage
Other risk factors include: • High blood pressure, stress, diabetes, or being overweight • Short time between pregnancies (6–18 months) • Certain infections during pregnancy such as a uterine, vaginal, or urinary tract infection or sexually transmitted disease • Smoking, drinking alcohol, or using illegal drugs
Have you unexpectedly delivered a preterm baby (before 37 weeks) in the past? Visit www.pretermbirthrisk.com to: • Listen to a pregnancy care provider to learn more!• Hear from moms about their experiences with preterm birth Talk to your healthcare provider if you would like to learn about preterm birth risks and what you can do to reduce your risk.
Marketed by Lumara Health, a division of AMAG Pharmaceuticals, Waltham, MA 02451 ©2015 Lumara HealthTM 17-884 10/15
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Sleep More to Lose Weight BY BRITNEY BLAIR, PSYD, CBSM
You probably already know about the importance of sleep for overall health and wellbeing. Healthy sleep can give you the energy and mental clarity you need to make it through your busy day. However, did you know that healthy sleep could also be the key to helping you maintain a healthy weight? We live in crazy busy times. It seems the technology designed to make us more efficient has allowed us to continue our work life after hours and jam more play dates into our over-packed schedules. We attempt to keep up with family, work, home, friends and our health. Polls show we’re also spending more time than ever trying to improve our appearance and prioritize our health. Something’s gotta give—and unfortunately, for many, trying to squeeze a few extra hours out of the day comes at the cost of shorter nights and less sleep. DON ’T SACRIFICE YOUR SLEEP Sleep is crucial for memory and learning, immune system functioning, emotion regulation, heart health, muscle repair and growth, healthy aging and regulating hunger. Mental and physical performance is directly and dramatically impacted by poor sleep. Scientists are discovering new evidence of the incredible power of sleep every day. Healthy sleep is important for healthy weight loss. There are two important hormones that regulate our appetite, which may be the most significant factor in weight gain or loss. Ghrelin is our “hunger hormone,” that regulates our appetite and energy distribution. Leptin is our satiety hormone; it signals when we’re full and have eaten all we need. Not getting enough sleep, or poor quality sleep, revs your appetite by boosting ghrelin and lowering leptin. You wake up feeling hungrier after a rough night’s sleep and your body isn’t able to send you the property hunger/satiety signals:
IMPROVE YOUR SLEEP QUALITY Protect and promote your own sleep with these 5 proven healthy sleep habits: 1. Maintain a stable sleep schedule: Get up at the same time each morning. 2. Avoid caffeine after lunchtime: This means foods or drinks that contain caffeine. 3. Break before sleep: Try to insert up to an hour’s break between your busy day and your time to sleep for at least 3060 minutes. 4. Make your bedroom a sleep sanctuary: Ideally it is cool, dark, safe and quiet. 5. Confine exercise to earlier in the day: Exercise is great for sleep (and weight loss) but try not to exercise within a few hours of bedtime.
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HOW MUCH SLEEP DO I NEED?
IMAGES © 123RF
Short sleep = HIGHER ghrelin + LOWER leptin eat more weight GAIN
Long sleep = LOWER ghrelin + HIGHER leptin eat less weight LOSS/STABILITY
We spend nearly a third of our lives asleep. How much sleep we need is fairly stable across our adult lifespan. Adults generally need between 7 to 9 hours of sleep each night; some may need slightly less and others slightly more. DR. BRITNEY BLAIR is a licensed clinical psychologist, is board certified in behavioral sleep medicine, and is adjunct faculty at The Stanford Center for Sleep Sciences and Medicine.
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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healthy moms
DRINK ’TIL IT ’S PINK?
Think Again BY CATHERINE RUHL, CNM, MS
You can drink until the line on the pregnancy test is pink, your girlfriends say. Sounds catchy and you like not putting your life on hold until the magic moment of conception occurs. But you wonder: Are there reasons not to drink while you’re trying, and hoping, to become pregnant? As with all health decisions, consider the evidence so you can make an informed choice that you can live with later. Here’s what you should know:
What about alcohol and men ’s fertility? Men don’t get a pass either. Heavy drinking can lower a man’s testosterone and sperm counts as well as decrease libido and even cause impotence. It’s recommended that guys drink within the guidelines for moderate alcohol consumption; the CDC says that’s not more than 2 drinks a day. When I ’m trying to get pregnant, what is the riskiest time during my monthly cycle to drink alcohol? If you have a 28-day cycle, ovulation occurs around the 14th day after the first day of your last period. So, starting at mid-cycle you could be pregnant. In the 2 weeks between ovulation and when a pregnancy test could show the magic pink line the biggest risk of drinking is miscarriage. Alcohol can prevent a pregnancy from implanting on the lining of your uterus so heavy drinking or binging is particularly risky.
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Can drinking in early pregnancy affect my baby? The first 8 weeks of pregnancy are called the embryonic stage; this is when your baby’s organs and systems are forming. It’s important to avoid any alcohol during this time because it can cause significant birth defects. Many women don’t know they’re pregnant in those earliest weeks. So, if you’re not using birth control and you’re having sex, you shouldn’t be drinking alcohol during this time. If you drink during pregnancy, after this earliest stage, alcohol’s effects on your baby’s brain may cause future behavior and learning problems—a condition known as fetal alcohol spectrum disorder (FASD). The bottom line about drinking and pregnancy? When it comes to drinking, there’s no safe time in pregnancy, no safe amount and no safe type of alcohol. CATHERINE RUHL, CNM, MS, is director of women ’s health for AWHONN, which publishes Healthy Mom&Baby.
What’s 1 Alcoholic Drink 1 Drink:
12 ounces of 5% beer, 8 oz 7% malt liquor, 5 oz of 12% wine, 1.5 oz hard liquor
Binge drinking:
4 or more for women, 5 or more for men on one occasion
Heavy drinking:
8 or more per week for women, 15 or more for men Source: CDC
IMAGES © 123RF
Does drinking affect my fertility? Yes, several well-done studies have shown that drinking even 1 to 5 drinks a week decreases a woman’s fertility. Women undergoing in vitro fertilization showed a significant decrease in their odds of a live birth when they drank 4 or more drinks per week, according to Harvard University.
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“Because every birth defect has a cause” “Why My Child?” It’s the question every family asks when they have a child with a birth defect. We help to answer that question DQG VXSSRUW WKH IDPLO\ ZLWK VSHFLÀ F information about their child’s birth defects. We also connect families who have children with similar problems. And provide referrals to support groups and resources their child may need. BDRC also sponsors the National Birth Defect Registry, a research project designed by prominent scientists to collect data for studies of the unknown causes of birthFOR CWF LOGO (W/ TYPE) GUIDELINES defects. No Smaller Than 1.5”
SPOT COLOR
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www.birthdefects.org
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Health4mom.org is the premier site for moms-to-be and new moms. It provides a host of features, covering everything from proper nutrition to best birthing options, promoting the optimal health and wellness for mom and baby. Visit Health4mom.org often to get news and articles covering the health topics that moms-to-be and new moms care about.
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healthy moms
KNOW YOUR OPTIONS FOR
Parental Leave BY K AITLYN DIXON
POST-BIRTH RECOVERY TIME NEEDED
A new baby’s birth is a life-altering event that requires time and energy to adjust to. Your body needs to rest and recover, and being home with your newborn protects and promotes your physical and emotional health, and your baby’s healthy development. Newborns are a lot of work, night and day, and they completely transform your schedule, your relationships, and everything else in your life. Taking time off work helps you stay rested and meet your changing family’s needs. When your partner also takes leave, you can adjust to the new normal together. Studies show that dads who take longer leave with their newborns are more involved in the caretaking responsibilities
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and stay more involved even a few years later. Ideally, both you and your partner would be able to take extended leave with your newborn before transitioning back to work, as desired.
POST-BIRTH RECOVERY TIME NEEDED
A quick glance around the globe reveals that most countries provide some sort of paid family leave, typically around 5-6 months, according to Pew Research Center: B France offers 4 months of fully paid maternity leave, plus additional family leave up to 6 months on partial pay B Ireland guarantees 10 months maternity leave on partial pay B UK gives a year of maternity leave, and 2 weeks of leave for dad, both on partial pay B US provides 12 weeks of unpaid leave through the Family and Medical Leave Act (FMLA) if you work for an employer with at least 50 employees, and you’ve been working there for at least 1 year What if you’re among the 40% of American workers who don’t qualify? Keep up to date with changes in family leave laws at dol.gov/whd/fmla/
IMAGES: 123RF
The United States is one of only a few countries in the world without paid maternity leave. Some states have paid medical leave, and some employers offer benefits for new parents. Two-thirds of all women who birth in the U.S. each year are working women who plan to return to their jobs. Our overview can help you learn your options and plan ahead so, as possible, both you and your partner can spend time with your precious newborn.
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healthy moms ADDITIONAL LEAVE BENEFITS IN SOME STATES Some states that are more generous than federal laws require, reports the National Partnership for Women and Families. If you live in any of these states, learn the full benefits offered and take advantage of them! There may also be laws in process or recently passed in your state-paid medical leave is a popular issue, so contact your local representative to advocate for any changes you support. Or, if you want to see changes in federal policies, contact your state representative. You can keep up with changes at the state level through advocacy groups, such as the National Partnership for Women & Families at PaidSickDays.org. As of the time of this writing, the following benefits were available in these states:
STATES WHERE SOME LEVEL OF PAID PARENTAL LEAVE IS FUNDED:
STATES THAT MANDATE PAID SICK LEAVE THAT CAN BE USED FOR PARENTAL LEAVE:
B California B Hawaii B New Jersey B New York B Rhode Island
B Connecticut B District of Columbia
STATES WHERE FMLA IS EXPANDED TO OFFER MORE WORKERS JOBPROTECTED MEDICAL LEAVE OR LONGER UNPAID LEAVE:
B California B Connecticut B District of
Columbia B Hawaii B Iowa B Louisiana B Maine B Massachusetts B Minnesota B Montana B New Hampshire B New Jersey B Oregon B Rhode Island B Tennessee B Vermont B Washington B Wisconsin
FLEXIBLE LEAVE Maybe you’re among the 13% of Americans whose employers provide paid parental leave—if so, enjoy it! Some employers may also be willing to work out a flexible plan with you. Options may include working from home, taking a longer leave on partial pay, or returning part-time and gradually working up to full-time again. Figure out what works for you and your employer, and remember when you negotiate good parental leave, you also pave the way for the moms and dads who come after you.
KAITLYN DIXON is a public health educator who writes for Healthy
Mom&Baby
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Creative
From Reveal to Birthday Parties, Here’s Fun with a Healthy Twist!
Celebrations
B
BOY OR GIRL?
Throwing a party to reveal baby’s gender? Or celebrate your little one’s birthday? Modern celebrations are as much about the message as they are the food and festivities. Building anticipation for the big event is an important part of the process, from posting clues and hints on Facebook and supporting the party’s theme on Pinterest to gathering your RSVP’s socially. Start the conversation early and keep it going so that guests experience your gathering as the pinnacle event. Healthy Mom&Baby gathered advice from party planner and baker Deepa Alfano at The Creative Spatula in Sarasota so that you can make everything perfect.
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B Let the food & refreshments help build the suspense: Tinted sweets and other foods in popular baby colors will keep your secret a little while longer. Here blue and pink owl and elephant cookies invite guests to guess at the gender as they nibble. B Be Democratic: Let guests vote blue or pink on a tote board, via a marble jar or by wearing strings of beads in their preferred gender color. B Ready, Set, Action! Balloons boxes are fun but so are creatively wrapped silly string canisters, confetti-filled balloons, or a colorful piñata that reveals the news!
IMAGES: DEEPA ALFANO; FACEBOOK .COM/ THE CRE ATIVE SPATUL A
Skip the tinted cake or beer, gender parties with action reveals are really popular right now—especially when you can stage a surprise for everyone involved, including mom and dad. It all begins with asking your healthcare provider to write down your baby’s gender and placing the information into a sealed envelope. Sharing that information with party providers will be easy and allow you to join in on the surprise as well.
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BABY ’S FIRST BIRTHDAY BASH Planning a healthy party for your child doesn’t have to be stressful. Deepa takes themes to the extreme with her fun ideas and favors all while keeping the sugar rush in check. “Emphasize personalized decorations and fun activities over food,” she advises. B Stave off the sugar rush: Offer healthy snacks like fruits and veggies before offering sweets B Agua as a party favor: Serve bottled water all dressed up in personalized labels or festive lemonades in old fashioned canning jars with sippy straws that echo the party theme instead of sweet juices and fizzy drinks B Delight with fun finger foods: Popcorn in colorful themed paper cones are far more festive than candy and chips in bowls B Plan for rain or shine: Pick a theme that works as well indoors as out should the weather not cooperate. Rainbow parties, under the sea and other colorful themes work in any venue B Keep the party going: Scatter fun and interesting picture frames for Instagram-worthy selfies of moms and their little ones, provide ribbons ala streamers on party sticks to move along with music and a guest book featuring the guest of honor’s image to capture fun stories shared during the event
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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Love is in a pump this comfortable Lots of new mothers told us expressing milk isn’t always easy. So we made comfort a priority. Our breast pumps let you sit upright and relax as soft massage petals gently stimulate milk flow. Breast pumps may be available through your health insurance providers. Learn more at philips.com/Avent.
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healthy moms MAKE MINE HEALTHY PLEASE Deepa started baking her own cookies and cakes because she wanted to skip of all of the additives in store-bought baked goods and mixes. “Even some bakeries use box mixes and use shortening instead of butter, increasing the level of trans fats,” she says. Deepa chooses themes for parties that work well with the healthy foods she plans to serve. For example, her daughter Sienna wanted a rainbow theme party for her third birthday so Deepa served a rainbow of fruit for snacks alongside bites of cucumber and cherry tomatoes with clouds of low-fat cream cheese. Of course a birthday cake and cookies were also on the menu, but the children were drawn to the colorful fruit cups first instead of the handmade cookies, she exclaims! Deepa bakes all of her own cakes and cookies from scratch, using all natural ingredients. These simple changes make healthier cakes and cookies that taste great, letting the natural flavors come through instead of drowning them in processed sugar. “Don’t be afraid to bake your own cakes and cookies. It’s no more difficult than using a mix.” Here’s how she adds healthy into her catered delightful goodies: t $VU UIF TVHBS CZ Ń OP POF XJMM NJTT JU t 4VCTUJUVUF PG UIF nPVS JO B SFDJQF XJUI whole wheat flour.
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Join us on Facebook facebook.com/HealthyMomAndBaby
healthy
Pregnancy
Prepare to Begin Breastfeeding Baby at Birth
BY SUMMER HUNT
Breastfeeding is the easiest and most rewarding way to bond with your baby; you ’re providing her with nourishment and personalized nutrition while you get a boost of happy hormones that bring you both closer. Moms who begin to nurse their babies right after birth, and continue through their hospital stay, achieve the greatest success with breastfeeding while reaching their baby feeding goals. Check out our newest Parent Pages and videos that are designed to help you prepare to breastfeed your baby, as well as work with your nurse to begin breastfeeding your baby at birth. Our latest videos, How Will My Baby and I Begin Breastfeeding? (bit.ly/beginbreastfeeding) and How Do I Prepare for Breastfeeding? (bit.ly/preparebreastfeeding) feature educator and Healthy Mom&Baby advisor Charlotte Wool, PhD, RN. Download brand-new Parent Pages on breastfeeding with even more advice to get you on the right track at bit.ly/breastfeeding-basics.
B PREGNANCY MAY MEAN FEWER MIGRAINES, NOT MORE
Prevent diaper rash: No ifs, ands or…well, you know
IMAGES © 123RF
If you suffer from migraines, you may actually experience fewer of them after becoming pregnant, particularly in the 2nd and 3rd trimesters. “This is likely due to a rise in estrogen levels, ” says Dr. David W. Dodick, professor of medicine at the Mayo Clinic School of Medicine. However, a recent study found women with migraines are also at risk for vascular problems, have more sleep complications, and seem to be more overweight during pregnancy. To avoid these issues, keep your blood pressure and cholesterol under control and stop smoking before becoming pregnant. Talk to your nurse about any medications you may be taking to treat migraines.
Diaper rash got you feeling frustrated? This painful condition is common in babies 9 to 12 months old and usually clears up quickly with care. Download brand-new Parent Pages on diaper rash on Health4Mom.org at bit.ly/ diaper_rash. You ’ll learn how diaper rash develops and what different types look like, as well as how to treat and prevent it. Keep your baby clean and dry and promote healthy skin!
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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A Mess a g e fr o m H a p p i T u m m iŽ F o u n d e r . . . ! ) m (who’s also a m o
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healthy pregnancy
6
Simple Strategies
for Healthy Pregnancy Eating BY RENE FICEK, RD
Despite all of the well-meaning advice you receive, eating healthfully in pregnancy doesn’t have to be overwhelming. Take it from me—a registered dietitian and a new mom—these 6 strategies are all you need!
IMAGES: 123RF
CONSUME ENOUGH FOLIC ACID, IRON AND PROTEIN It ’s smart to start with a prenatal vitamin even before you ’re pregnant — and to continue it after baby ’s birth until you end breastfeeding. In addition to the other nutrients, your prenatal gives you folic acid to reduce the chances of neural tube defects like spina bifida. In addition to your prenatal vitamins, eat dark leafy greens, broccoli and citrus fruit. During pregnancy, your blood volume increases to support your baby and placenta. It ’s not uncommon for pregnant women to need additional iron. Consume plenty of dark leafy greens, soy, beans, lentils, seeds, and even some red meat to boost your stores. Add citrus everyday to help your body absorb more of the nutrients when you eat iron-rich foods. Your protein needs actually double in pregnancy to support fetal growth and milk production. Many pregnant women actually fall short of this recommendation. The kind of protein you eat may be as important as the quantity, as a growing body of evidence suggests that protein requirements can be more safely met by eating more vegetable proteins rather than more animal proteins. If you haven ’t met these great protein sources yet, search for recipes that include high-protein grains like quinoa, and other veggie proteins including beans, legumes, lentils, nuts and seeds.
COOK FOODS PROPERLY All meat, fish, and eggs need to be cooked to recommended temperatures to avoid food-borne illness, specifically a bacterial infection called listeriosis. While its rare, you can encounter it in foods like lunchmeats and it can be fatal for your developing baby. To avoid food poisoning and illnesses remember the following: Seafood: No sushi, sashimi or raw oysters. Cooked shellfish is fine, but avoid any fresh mussels or clams that haven ’t opened during the cooking process. Avoid refrigerated, uncooked seafood like nova style lox and smoked fish. It ’s okay to eat smoked seafood if it ’s an ingredient in a casserole or cooked dish. Canned and shelf-stable versions also are safe. Always cook fish to an internal temperature of 145º F. Processed meats: There ’s a chance listeriosis may lurk in ready-to-eat foods such as hot dogs and deli meats because contamination can occur after cooking and before packaging. Avoid all processed meats unless you ’re certain they ’ve been steamed to160º F. Animal proteins: All meat needs to be cooked thoroughly, this means eating and ordering all steaks to about medium well, or at least 160º F. Most meat (besides chicken) should be cooked to 160º F; this includes pork, ham, eggs, and ground meat. Chicken should be cooked to 165-180º F. Avoid refrigerated pâtés or meat spreads.
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healthy pregnancy
LIMIT CAFFEINE Whether caffeine in pregnancy is safe is an age-old controversy. While some caffeine is safe, it can be an issue if you consume large amounts. You ’re especially sensitive to caffeine when you ’re pregnant because it lingers in your system longer than when you ’re not pregnant. Studies show caffeine crosses the placenta, and your baby ’s developing metabolism isn ’t quite ready for a java jolt. It can reduce blood flow to the placenta, affecting birth weight. When it comes to any food or drink with caffeine, take in no more than 200 mg/day. That ’s about a 12-ounce up of regular coffee.
SKIP UNPASTEURIZED PRODUCTS
AVOID FOODS HIGH IN MERCURY Seafood is a great source of protein, and the omega-3 fatty acids in many fish can promote your baby ’s brain and eye development. However, some fish contain potentially dangerous levels of mercury. Too much mercury could harm your baby ’s developing nervous system. Avoid fish known to have the highest levels of mercury: swordfish, shark, king mackerel and tilefish. And when it comes to canned or jarred tuna, be sure to look for tuna labeled as “light ” since it tends to have less mercury than white or albacore tuna. Check the label —make sure your “light ” tuna comes from skipjack, which is lower in mercury; and limit tuna servings to 2 meals a week.
More than just milk is pasteurized. Many soft cheeses are actually made from unpasteurized milk, and unpasteurized dairy products may contain the bacteria listeria, which can cause miscarriage. Listeria crosses the placenta and may infect your baby and can be life-threatening for your developing little one. Avoid soft cheeses such as: Brie, Camembert, Roquefort, Feta, Gorgonzola and Mexican-style cheeses that include queso blanco and queso fresco, unless they clearly state that they are made from pasteurized milk.
GAIN A HEALTHY AMOUNT OF WEIGHT Half of all pregnant women gain too much weight during pregnancy. This not only makes it difficult to lose that post-baby weight, but more importantly it puts you at an increased risk for preeclampsia, gestational diabetes and birthing either a preterm or a too-large baby. Too little weight gain can also be problematic as it puts you and your baby at risk for birthing early or your baby for having a low birth weight.
RENE FICEK, RD, is the lead nutritional expert at Seattle Sutton ’s Healthy Eating.
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Keep in Touch
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Baby Sonogram Jewelry by Jill Campa Designs
Let us transform your baby’s sonogram (ultrasound photo) or footprints into beautiful keepsake jewelry and accessories. www.babysonogramjewelry.com www.jillcampadesigns.com
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13/11/2015 People are amazed when I tell them I was so comfortable and happy during my childbirth. Hypnobabies’ hypnosis worked so well for me that when I finally came to the hospital, they almost turned me away because they didn’t believe it was time for my daughter to be born. I permitted them to check me, and I was seven centimeters dilated. After our birth, my doctor said, “I’ve forgotten how beautiful a natural birth can be!
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healthy pregnancy 1st
Trimester:
Understand Ultrasound:
Meet Your Developing Baby
IMAGE CREDITS: 123RF
BY AWHONN EDITORIAL STAFF
Th anks to amazing developments in ultrasound technology, you can now see your baby and hear his heartbeat from his earliest stages, when his heart starts to beat around the 5th week of pregnancy. During your pregnancy, ultrasound is helpful to your healthcare providers in verifying that your pregnancy is progressing normally, calculating your baby’s gestational age and size (which is the most accurate in the fi rst trimester but can vary by as much as 2 weeks after that). It can also be used for investigating potential problems, such as with your placenta, and for guiding needle placement if you undergo amniocentesis or chorionic villus sampling, which are tests your provider may recommend that check for genetic problems during prenatal care. To create an ultrasound image, highfrequency sound waves are transmitted through your abdomen (don’t worry, your baby can’t hear these sounds), and the echoes are then converted to a video image of your baby in your womb. Most ultrasounds are performed externally via your belly, but they can also be done via vaginal probe, although this is less common.
ULTRASOUND SAFETY If you ’re wondering whether ultrasound is safe, rest assured that routine ultrasound during pregnancy is generally considered safe, says the FDA. Unlike X-ray, there ’s no ionizing radiation exposure during an ultrasound scan. Still, experts at the Mayo Clinic and FDA warn against using ultrasound just for video or keepsake pictures because technicians at commercial facilities (not a healthcare provider) may not give you accurate or reliable information. In fact, they may actually give you misleading or potentially risky information. The FDA also cautions against over-the-counter fetal heartbeat monitoring systems (doptones) as they could expose your baby to prolonged and unsafe energy levels.
ULTRASOUND BY TRIMESTER Here ’s what you can expect regarding ultrasound during your pregnancy.
1st
TRIMESTER
Unless you have complicating factors, you ’ll likely have to wait until the 2nd trimester for your first peek at baby. Ultrasounds in the 1st trimester are usually only performed to get an accurate gestational age of your pregnancy, to confirm a suspected high-risk pregnancy, to confirm the success of a pregnancy via IVF, or to reassure a woman who has had multiple miscarriages that the pregnancy is viable and progressing, for example.
2nd
3rd
TRIMESTER
This is the moment you ’ve been
waiting for, the chance to see baby for the first time and to possibly learn whether baby ’s a he or she. Your provider will also want to use ultrasound to take measurements, including measuring your baby, and to check the health and position of your placenta. Your amniotic fluid volume will also be measured. If all remains well, this may be the only scan you receive during pregnancy.
TRIMESTER
As your pregnancy nears term you may undergo ultrasound if baby is breech or if his or her size isn ’t measuring accurately against the expected gestational age ranges. If you experience complications, your provider may request a scan to check your baby, placenta and fluid volume.
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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.
Don’t rush me!
While it may seem convenient for you or your health care provider, labor should only be induced for medical reasons. G me ive tim e
Go
Your baby will let you know when he’s ready to come out, so give him at least a full 40 weeks.
.
f 40 or !
Download a free copy of
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The nurses of AWHONN remind you not to rush your baby—give him 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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2nd
Trimester:
healthy pregnancy
Your Blood Sugar Matters in Pregnancy Understanding Gestational Diabetes
BY ELIZABETH “BET T Y ” T. JORDAN, DNSC, RNC, FA AN
B
QUIZ: ARE YOU AT RISK FOR GESTATIONAL DIABETES? Take this quiz developed by the experts at the National Institute of Child Health & Human Development to learn if you ’re at risk for developing gestational diabetes. Check each box for which you can answer “Yes: ”
BLOOD GLUCOSE TESTING
IMAGES: 123RF
Gestational diabetes is a form of high blood sugar that develops in pregnancy, and it can cause serious problems that put you and your baby at risk including: B high blood pressure B preeclampsia (a sudden, dangerous increase in blood pressure) B pregnancy loss during the last 4 weeks to 8 weeks of pregnancy B preterm labor and birth B cesarean and its risks When you eat, your body breaks food down into a sugar called glucose. This sugar passes into your bloodstream from your stomach, and a hormone called insulin acts like a key, unlocking cells so the glucose can go inside and be used for energy. Diabetes develops when insulin fails to move blood sugar into your cells, leaving it circulating in your bloodstream. Every pregnancy is different. You can develop gestational diabetes in any pregnancy, and even if you’ve had it in a previous pregnancy, you may not have it with a subsequent pregnancy. If you’re diagnosed with gestational diabetes, you’ll need to closely control your diet and exercise to keep your blood sugars in norm ranges. Developing gestational diabetes puts you at risk for developing diabetes later.
B Testing typically occurs between weeks 24-28 B First test is the 1-hour glucose tolerance test (GTT); this test involves drinking a sugary liquid and having your blood drawn 1 hour later to determine your blood sugar level; if all is well you can typically finish pregnancy without further testing B Additional testing is the 3-hour GTT and you may need that if you don’t pass the 1-hour test. You’ll likely be asked to fast overnight, avoid caffeine, and don’t smoke for 12 hours before testing. With the 3-hour GTT, your blood sugar levels are checked at 1, 2 and 3 hours.
Are you overweight or obese? Are you related to anyone who has, or has had, diabetes? Are you Hispanic/Latina, African American, American Indian, Alaska Native, Asian American, or Pacific Islander? Are you older than 25? In a previous pregnancy, did you have any of these issues: x Gestational diabetes x Stillbirth or miscarriage x Baby weighing more than 9 pounds Do you have polycystic ovary syndrome (PCOS)? Have you ever had problems with insulin or blood sugar, such as insulin resistance, glucose intolerance or “prediabetes? ” Do you have high blood pressure, high cholesterol or heart disease?
TOTAL “YES ” ANSWERS ...
YOUR YOUR HEALTHCARE GESTATIONAL PROVIDER MAY . . . DIABETES RISK IS . . .
2 or more
High
Test as soon as you know you ’re pregnant. If your first test is negative, test again between 24-28 weeks pregnant
1
Average
Test between 24-28 weeks pregnant
0
Low
May not test or will test between 24-28 weeks pregnant
Source: NICHD
ELIZABETH “BETTY ” T. JORDAN, DNSC, RNC, FAAN, is an expert advisor to Healthy Mom&Baby.
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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healthy pregnancy
3rd
Trimester Changes:
HOW YOUR BODY PREPARES FOR BIRTH BY JOANNE GOLDBORT, PHD, MSN, RN
You’re headed into the third trimester (weeks 2840) of your pregnancy and wonder what changes to expect as you get closer to giving birth. This trimester brings moments of anticipation and excitement as you move away from the more restful past 12 weeks and into a period of increased growth and changes as your body gets ready for birth. Let’s look closer at what some of those changes may be. GOODBYE SLEEP! As your baby’s body continues to gain weight, develop and mature, you may find it difficult to sleep at night, especially during the last few weeks of pregnancy. Perhaps you’re noticing increased heartburn due to added pressure on your diaphragm. Relief for both of these issues will happen when the baby “drops” or settles into the pelvis around the last few weeks of pregnancy. This is known as “lightening.” You may or may not notice when your baby does this subtle movement but friends and family will, so expect statements, such as, “oh, you’re getting closer as your belly looks lower!” Heartburn may also diminish during this time but be replaced by increased pressure on your bladder and the urge to use the bathroom more frequently. Even sleeping restfully gets more difficult as you get closer to birthing your baby. WATCH FOR THE MUCUS PLUG When your baby moves into your pelvis, more pressure is put on your cervix, and you may even lose the mucus plug that sits inside the cervix. You may notice this happens when you wipe after urinating—a thick, clear, gloppy substance may appear on the toilet paper. No need to worry; this is normal, and for some women it’s a sign that birth is getting closer. PREPARE FOR BIRTH If you haven’t already done so yet, attend childbirth classes to learn more about labor and birth, and meet other women going through the same experiences as you. You’re nearly finished with pregnancy. In these last weeks remember to get plenty of rest, drink lots of water, continue to be active, and eat a wellbalanced diet. Soon you will meet your baby!
3rd Trimester Warning Signs Call your healthcare provider if any of the following happens:
B Your water breaks. This may happen as a trickle of clear fluid that at first may seem like you have to urinate but continues even after you go to the bathroom. Or it may be a gush of fluid. Either way it ’s important to get this checked out —you very well could be headed quickly into labor!
B You have bright, red bleeding B You have contractions or tightening of your belly that occur regularly —about 5 minutes apart, lasting for a minute or so and continuing for at least an hour
B You have a headache or heartburn that won ’t go
away after taking over-the-counter medications for the problem
JOANNE GOLDBORT, PHD, MSN, RN, is an expert advisor to Healthy Mom&Baby.
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healthy pregnancy
What is
Gentle Cesarean? BY K AITLYN DIXON
Birthing surgically by cesarean section hardly seems something you’d call gentle, but a new term is emerging to describe how some hospitals are trying to make surgical birth a more family-centered experience: Gentle Cesarean.
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your chest, where baby will rest skin-to-skin with you while your incision is closed. If you’re unable to hold baby, your partner will have the opportunity to go skin-to-skin with your little one. BENEFITS OF GENTLE CESAERAN Proponents of gentle cesarean say the many benefits include a more positive and emotional birth experience, a more family-centered birth experience, and the all important opportunity for baby to go skin-to-skin with mom right at birth, and begin breastfeeding. Research has well-documented what’s called the Golden Hour: Skin-to-skin with you immediately in that first hour following birth, baby’s breathing and blood sugars stabilize, baby is better able to hold a consistent body temperature and to begin breastfeeding. Most mother/baby experts know that placing baby skin-to-skin with mom or dad is the very best way for bonding and recovery to begin; they encourage it after normal birth. Offering skin-to-skin after a cesarean is less common, but no less important or beneficial. Some obstetricians speculate gentle cesarean could even help reduce postpartum depression, which is more common in mothers with cesarean births—this remains to be studied, however.
IMAGES: THINKSTOCK
WHAT IS GENTLE CESAREAN? Also called a family-centered cesarean or natural cesarean it’s the same surgery but performed more gently, slowly and with increased focus on parent involvement in the birth. Surgery prep begins with an epidural or spinal pain block for you, mom, which numbs the lower part of your body while allowing you freedom of movement with your arms and head. This is quite different from a typical cesarean, in which a mom’s arms are strapped to the surgical table. During a gentle cesarean, your healthcare providers will also place the heart rate monitors and IV one side, giving you the freedom to hold baby to your chest with your preferred arm right after birth. Surgery starts with a surgical drape hung between your head and abdomen, but once baby’s head emerges during the procedure, the drape is lowered and replaced with clear plastic. Your nurses will help raise your head so that you and your partner can watch the rest of baby’s birth. Delayed cord clamping may also be an option in some hospitals; this allows your baby’s lungs to begin breathing while he or she is still receiving oxygen through the umbilical cord. If all is going well at birth, your surgical team will then move baby to
health4mom.org
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healthy pregnancy
Gentle cesare an carries all of the risks of surger y; it should only be performed fo r medical reas ons.
WHO CAN HAVE A GENTLE CESAREAN? Gentle cesarean doesn’t mean it’s any easier as it still carries all the risks of a cesarean surgery for mom and baby, and should only be performed for medical reasons. It’s not any more natural than a regular cesarean, which is extensive abdominal surgery. Cesarean surgery (including gentle cesareans) has more risks than normal birth. When a cesarean is medically necessary and is not an emergency, a gentle cesarean should be possible as long as both mom and baby are medically stable. However, your health and your baby’s health are always your provider’s first priority. So if there are complications like premature birth or health problems, gentle cesarean may not be possible. Keep an open and ongoing conversation with your healthcare providers about how you will birth your baby so that when the time comes, you can meet your new little one in the most healthy best possible way.
KAITLYN DIXON is a public health educator who writes for
B Consider Gentle Cesarean Whether you know you will need a cesarean birth, or want to be prepared just in case, here ’s what you can do: B Talk to your hospital in advance and ask if they can accommodate the following: x Skin-to-skin with baby immediately after cesarean x Keeping baby with you or your partner at all times x Starting breastfeeding in the operating room B Talk to your obstetrician about what to expect during a cesarean, and ask about watching the birth, delayed cord clamping, and immediate skin to skin. B Involve your birth partner in the discussions, so they can help voice your wishes.
Healthy Mom&Baby.
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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healthy pregnancy
Breastfeeding
(Success Strategies) BY SHELLEY GIBSON, BSN, IBCLC, AND MICHELE SAVIN, MSN, NNP-BC
You can meet your breastfeeding goals with a little planning, support, patience and these checklists!
The World Health Organization (WHO) and the American Academy of Pediatrics (AAP) recommend that infants exclusively breastfeed and consume only breastmilk for the first 6 months of life. These same experts also encourage you to nurse your baby for at least her first year and into her second year and beyond, as you both desire. Breastfeeding is normal and natural yet you may face challenges along the way. Use these strategies and recommendations to achieve the nursing you desire with baby.
Learn a b ou t br e as t feedin g w he n yo u pr eg n a r e a Ga t h e n t . inform r the ation a nd su p p o r t yo u need! ’ll
IMAGES © 123RF
DURING PREGNANCY Talk to your family and friends about your plan to breastfeed; ask for their support with your other children, housework and meals. Join an online breastfeeding support group or find nursing moms through Women, Infants, and Children’s (WIC) programs, La Leche League or a local hospital. Talk with your nurses at your healthcare provider’s office. Ask their advice on preparing for breastfeeding, including finding a breastfeeding class, a nursing support group, and a breastfeeding friendly healthcare provider for baby. Take a breastfeeding class; ask how you’ll be supported to start and continue breastfeeding where you plan to birth. Ask about your hospital’s policies on beginning breastfeeding at birth including cesarean birth, and on “rooming-in” or keeping baby in your room instead of in a nursery. Choose a Baby-Friendly® designated birthing center or hospital, which means healthcare providers there are committed to helping moms and babies succeed with breastfeeding. Get familiar with your changing breasts. You may start making your first milk, colostrum, as early as 16 weeks. Learn how to express your milk by hand. If you’re concerned about having flat or inverted nipples, have a history of breast surgery, or take medications, meet with your provider or a Certified Lactation Consultant to make a plan for nursing your baby. Check your health insurance benefits to see what’s covered to support breastfeeding, and register for nursing supplies before any baby showers you may have. Many plans cover breast pumps, milk storage bags, bottles and other supplies.
B
BEFORE BABY ’S BIRTH X Learn about breastfeeding and find other moms who share your goals X Talk to your partner and family about your goals X Talk to your healthcare providers and birthing center staff X Take a breastfeeding class X Shop for nursing bras, tops, pumps, milk storage bags and supplies X Plan to pack a breastfeeding positioning pillow, nursing cover, nursing bras and shirts, breast pads, and nipple cream for the hospital
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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healthy pregnancy AT BABY ’S BIRTH When your baby is born, hold him skin-to-skin right away; your partner can do this too when you’re relaxing. Ongoing skin-to-skin care is the perfect way to start and sustain breastfeeding. If your baby hasn’t had many medications through labor and birth, he’ll likely be born awake, alert and ready to feed in that first “golden hour.” Holding baby skin-toskin keeps him warm, helps him hear your heartbeat, feel your breathing, and smell the milk. Ask your nurses to delay weights, measurements, and medications until after baby’s first feeding or for at least the first hour after birth. When you’re tired and need to rest, the safest place for baby is in his bassinet beside your bed. Rooming-in will help you stay close to learn his hunger clues so that you can respond to his needs. Feed baby every time he seems hungry, and allow him to remain at the breast for as long as he desires—many babies often fall asleep at the breast and there’s no need to wake them. Just hold them close, keep them warm, and snuggle. During the earliest days, your baby needs to nurse about 8-12 times every 24 hours. You may even need to rouse baby if he’s slept more than 3-4 hours without waking to feed. Your nurses will help you find comfortable nursing positions, particularly if you’re also recovering from cesarean. The best position is the one that feels comfortable for both you and your baby. Help baby into position, watch for a deep latch with a tugging feeling at your breast. Ask your nurses to watch baby latch and begin to feed; they want to help you get the best possible start and are eager to share their expertise. Delay a pacifier for 3-4 weeks; this lets baby learn how to breastfeed and helps your milk come in. If you’re separated from your baby for any reason, support your milk supply by expressing your milk with your hands or a breast pump as regularly as baby was nursing at the breast.
SUSTAINING NURSING Getting through the first few days and weeks can be tough. You will be tired, and adjusting to new routines. Your breasts are suddenly full and your baby’s eating patterns may change. You may question whether you have enough milk, or if you should begin pumping because you have so much. Breasts can get tender and nipples sore. This is the time to call on your support system! Partners can burp your baby; change diapers, and make sure you have plenty of food, water, and rest. Keep a feeding and diaper log. Follow your baby’s hunger signs and allow her to regulate your milk supply through her nursing. Text or talk to other moms online or call your nurse or a breastfeeding specialist. You will want to get out of the house, so do! Breastfeeding is convenient on the go. Your breastmilk is always the perfect temperature and you don’t have to worry about extra supplies or pumping. Most experts recommend waiting 3-4 weeks before pumping regularly to ensure baby has the hang of breastfeeding. If you’re returning to work or school, plan to take pumping breaks throughout the day and know your rights regarding these breaks. State and federal laws exist to protect nursing moms. Plan for a place to store your milk and clean your supplies.
B
AT HOME & BEYOND X Accept help from loved ones X Continue to breastfeed on demand X Keep a feeding and diaper journal X Allow baby to regulate your milk supply X Gather with other nursing mothers for support X Use nursing covers or tops at your preference to nurse in public X Ask about medication and birth control
SHELLEY GIBSON, BSN, IBCLC, is a certified lactation consultant and MICHELE SAVIN, MSN, NNP-BC, is an expert advisor to Healthy Mom&Baby.
B
BEGIN BREASTFEEDING AT BIRTH X Breastfeed as soon as possible after birth, including cesarean birth X Keep your baby close to you, holding her skin-to-skin and rooming-in X Breastfeed frequently —every 2-3 hours X Learn baby ’s hunger signs and cues X Ask your nurses and breastfeeding specialists for help and information X Try different nursing positions X Delay pacifiers and bottles until breastfeeding seems natural to you and baby
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Our Mother’s Choice Products are Midwife Approved and Pregnancy Safe Formulas. We feature a full line of products to aid in your pregnancy. Our products are Cruelty Free, Vegan Friendly and Gluten Free. Contract Ease - After Birth Pains and Uterine Cramps contains herbs traditionally used to support the female glandular and nervous system after birth. The formula was created by Shonda Parker, CCE, Clinical Herbalist, Author, Lecturer, CHANA President. Our Customer Reviews speak for themselves: “This absolutely works wonderfully. My after-pains were gone after taking only one dose.” - Stacey Hunter “I used this product after the birth of my third child. It worked very well. The pain of contractions after birth was much less than with my other two. I would highly recommend!” – Carly Campbell Please visit www.TriLightHealth.com for more information on our products. Important Notice: TriLight Health products are not meant to diagnose, treat or cure any disease or medical condition. These statements have not been evaluated by the Food and Drug Administration. Please consult your doctor before starting ANY exercise or nutritional supplement program or before using these or any product during pregnancy or if you have a serious medical condition.
1 Prepare now!
Breastfeeding Basics
It is paramount to prepare for breastfeeding before giving birth. Get educated by taking childbirth and nursing classes, reading books, and watching videos.
2
Create A Nursing Sanctuary Keep in mind that you must to be comfortable and everything you need is within arms reach. Have a comfortable chair to sit and rock in. Gather lots of comfy pillows to support your low back, arms, and hold the baby in a good position while you nurse.
3 Nourishment Your body is amazing! It can grow your baby, birth your baby, and it can feed your baby. But if you want your body to perform the way you want it to then you need to nurture it with healthy foods, lots of water and plenty of rest.
4
Get Support New mothers should be nurtured mothers. It takes a village to grow a child and it takes love and support to take care of nursing moms. Sometimes you need to seek advice from an expert. Those women who are trying to solve all their nursing problems alone, feel alone.
5 Stay Steadfast Don’t give in to the fear and the nay sayers-You can do this!
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healthy pregnancy MA NAGE AF TE RPAI NS B BREATHE: The same breathing and relaxing techniques you used during labor and birth will help with postbirth discomforts too. B REST: We often experience discomfort even more so when we’re tired. During these early days after birth, try to rest when possible—sleep when baby sleeps. Keep visitors away until you’re recovered, keep the lights low and your favorite mellow tunes on.
Afterpains Baby’s here and nursing; why am I still cramping like I’m in labor?
IMAGES: 123RF
BY CAROLYN “CARRIE ” J. LEE, PHD, CNE, RN
Baby’s here, and as you’re settling into nursing you feel cramping again—as if your body is still trying to labor. What’s up with that? These cramping pains are called afterpains and they’re normal. In the days after birth, the muscles of your uterus continue to cramp as they contract down over the vessels where the placenta was attached, helping the uterus return to its normal, non-pregnant size. This is a good thing because a firm, toned uterus after baby’s birth helps control how much you may continue to bleed. This discomfort is usually strongest in the first few days after birth but may be present for a week or so. If this is your first baby, you might not feel them at all or they may be mild. Your girlfriends may have told you these afterpains are definitely stronger with a large baby, multiple babies or with each subsequent pregnancy. That’s true! Your uterus may have stretched more, or more often, and it’s working harder to stay firm and return to normal size.
YOUR SHRINKING UTERUS It can take up to 6 weeks for your uterus to return to normal, and your healthcare provider will check its size at your 6-week postpartum visit. You may also notice increased cramping while breastfeeding. This is a natural breastfeeding benefit and a great cue that baby is sucking well enough to release the hormone oxytocin, the same hormone that caused your uterus to cramp and begin labor. Now, that same hormone is working to help the uterus firm and shrink. If the cramping doesn’t ease over time, or it gets more intense with increased bleeding, call your nurse as you could have an infection or need care.
CAROLYN “CARRIE ” J. LEE, PHD, CNE, RN, is a
professor and expert advisor to Healthy Mom&Baby in Toledo, OH.
B EMPTY YOUR BLADDER: A full bladder can make cramping worse. Help your body release the extra fluids from pregnancy by drinking more and releasing more fluid. Expect to have to go frequently. B GET COMFORTABLE: Try lying on your stomach with a soft pillow tucked up close to your tummy. If you’ve had a cesarean, lying on your side with abdominal support may be more comfortable when you’re cramping. A warmed rice sock can also help and is preferred to a heating pad, in case you fall asleep. B USE PAIN MEDICATIONS: You received them just for this reason. Or if you don’t want something quite that strong, try ibuprofen. You’ll feel better and be able to enjoy your baby and nursing. Let your nurse know if the medications you’re using aren’t providing enough relief.
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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healthy
Babies
Join us on Facebook facebook.com/HealthyMomAndBaby
BY SUMMER HUNT
EVERYTHING You Need To Care For Baby’s Skin! From Preventing Diaper Rash to Sun Protection, It’s All Here Soft and sweet, your baby’s skin is truly amazing. Take care of that sensitive layer with tips and tutorials in our Newborn Skin Care Zone at Health4Mom.org. t )PX PGUFO TIPVME ZPV CBUIF ZPVS CBCZ t $BO ZPV EJBQFS UP QSFWFOU SBTI t 8IBU T UIBU CSFBLJOH PVU BMM PWFS ZPVS CBCZ T TLJO Find articles on bathing, diapering and rash prevention,
IMAGES © 123RF
CAN NAPS HARM MORE THAN HELP? Little ones age 2 years and older may not benefit from naps, say researchers, who reviewed nighttime sleep patterns in studies related to napping in children age 5 and younger. Children who napped during the day fell asleep later, had a poorer quality of sleep and got less sleep overall. Th is doesn’t necessarily mean your kiddo has to give up a mid-day snooze session: “Parents shouldn’t impose a daily nap on preschoolers who don’t seem to need or benefit from it,” says Andrew Adesman, chief of developmental and behavioral pediatrics at the Cohen Children’s Medical Center of New York.
sun protection and everyday care; test your skin care knowledge; and share your preferences in our polls. 6OFYQMBJOBCMF SBTI 6TF PVS 7JTVBM (VJEF UP $PNNPO Rashes in Babies and discover what might be ailing your little one. For any other quandaries, Ask Our Nurses! You can even download PDFs of our Parent Pages to keep info right at your fingertips. Get it all online at Health4Mom.org/zones/ newborn-skin-care.
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DO YOU DRONE PARENT?
Gone are the days of latchkey kids and limited supervision; now most parents keep their kiddos on a tighter watch. Drone parenting is pushing aside the popular helicopter parenting, thanks to new technologies, says parenting expert Stacy Debroff. Drone parenting allows you to keep close tabs on youngsters but remain out of sight and ready to strike at a moment’s notice. It may have started with night vision baby monitoring, but a whole new host of gadgets to help you up your parenting debuted at this year’s Consumer Electronics Show—all of which have accompanying smartphone apps: t Pacif-i: pacifier measures temperature and features location tracker t Grush: Bluetooth-enabled toothbrush turns dental care into game and tracks brushing habits t Owlet: baby bootie measures baby’s vital signs including breathing and pulse oximetry t 4leepIQ Kids: mattress monitors breathing, heart rate and tells parents if a child is out of bed; also features a monster detector and underbed light
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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healthy babies
Babyproof
Your Child’s World Through Age 2 BY RITA NUT T, DNP, RN
Your baby’s first 2 years are an exciting time of new discoveries and exploration. They have so much to learn and are very busy—almost in constant motion. Children explore their world by touching, experimenting and watching others. They can’t predict the outcomes of their actions, and they can’t think ahead—that’s what you get to do! Your baby will require constant supervision during her earliest years. Your baby will develop so quickly, seemingly acquiring new skills and tricks overnight! Long before you’ll need outlet covers and cabinet locks, there are many ways you can babyproof your child’s environment. Use these proven tips to protect her from the 8 most common dangers in her first 2 years of life.
BABYPROOFING: BIRTH TO AGE 1
FALLS Babies are little wigglers almost from birth. They kick their feet, wave their arms and squirm around; they can move themselves! Prevent falls by never leaving your baby alone on an elevated surface, such as a couch, bed, or changing table —even an infant swing or bouncer becomes unsafe if baby isn ’t securely fastened into the harness. If you have other children, teach them that they ’re not to pick up, lift or carry baby without your help and supervision. Little hands can easily drop baby, resulting in injury.
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CAR INJURIES Baby should always be restrained in a car seat every time they ’re in the car, whether it ’s your car, your caregiver ’s car or a taxi. It ’s safest for baby to ride rear-facing until age 2, when he ’ll likely outgrow his infant car seat. Baby never rides in a front passenger seat unless you only have a single cab truck; ensure the front passenger airbag is disarmed if baby must ride up front. Get baby ’s car seat installation checked at a fire or police station; they ’re hard to install correctly! And never forget you have baby in the vehicle, especially in temperature extremes when it ’s super cold or hot outside. Put a critical item —your purse, cell phone, briefcase or even the shoe from your non-driving foot —next to your baby in the back seat and you ’ll remember baby each time you leave the car. CHOKING Baby wants to put everything in her mouth! This is a huge choking risk. Keep small objects out of her reach. Use an empty toilet paper roll —if the item fits inside, it ’s a choking hazard. Use caution when introducing first foods; small crunchy bites can choke baby. Avoid round shapes, like grapes or hot dogs (in fact, avoid hot dogs altogether!). Cut foods into small, angular pieces for baby to pick up and enjoy.
IMAGES: 123RF
SLEEP INJURIES Baby needs a safe sleep space, in a crib designed just for babies and free of blankets, pillows, bumper pads and stuffed animals. Always place your baby on his back to sleep in order to help prevent Sudden Infant Death Syndrome (SIDS), which is the leading cause of death for children before age 1. Your baby should never share your bed; he can become trapped in the bedding, get rolled onto by an adult or fall out of the bed.
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healthy babies
TODDLER PROOFING: AGES 1-2 YEARS BURNS By now, baby is upright and likely walking, if not crawling fast and standing up with the help of furniture, chairs and tables. Your kitchen is a new danger zone! While cooking, keep the handles of your pots and pans turned away from the front of the stove so that little hands can ’t grab them. Install guards over your stove knobs to keep your toddler from turning the burners on. While your little one may love watching you stir a pot, never cook with baby in your arms —hot oils or liquids can splash and cause serious burns. Other burn hazards include barbeque grills, fire pits and fireplaces. POISONING Remember how everything goes in baby ’s mouth — that increases her risks for poisoning. Cabinet locks are essential, especially on lower cabinets, but it ’s an even safer practice to keep dangerous substances like cleaning supplies, dish detergent, vitamins and medications in a locked cabinet well above your child ’s reach. Never call medicine candy as this makes it more appealing and more likely to be ingested. Post the phone number for poison control near your home phone and in your cell phone —use it even if you ’re unsure as to what baby swallowed. FALLS Falls are more common during the toddler years. Hello baby gates, especially around stairs. Locks and guards are important for all windows, particularly on
Mos t p don ’t k eople now th at d r ow n t ypica ing is lly silen t — yo u w il he a r y l n o t our ch ild s trugg le.
the upper floors. Is your child a climber? Keep chairs, stools and anything stackable away from kitchen counters or tables. Heavy furniture, like shelves, bookcases and TV stands, should be bolted to the wall —even a set of drawers can become a tantalizing climb for adventuresome toddlers. For toddlers, climbing is fun! DROWNING You don ’t have to have a swimming pool to risk drowning: Any amount of sitting water poses a risk. A mere 2 inches is enough standing water for a child to drown. Empty all pails of water, drain bathtubs and sinks, and use safety alarms and fences around swimming pools. NEVER leave your child unattended in a bathtub or pool, even for a single minute. Most people don ’t know that drowning is typically silent — you will not hear your child struggle. CAR INJURIES CONTINUE As your child grows, don ’t be tempted to rush into booster seats meant for older kids —car accidents are still a major cause of death and injury among toddlers. Buckle your baby into an age-and weight-appropriate car seat for every car ride. And use your back-up camera; your mobile child is now at increased risk of being hit by a car or backed over as you leave the driveway. Always know where your child is and that she ’s safely in or away from the car before shifting into reverse. RITA NUTT, DNP, RN, is an expert advisor to Healthy Mom&Baby in
Salisbury, MD.
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Spray Goodbye to Diaper Rash Spray What?From the tried and true ointment to a revolutionary spray, Dr. Smithâ&#x20AC;&#x2122;sÂŽ offers a touch-free spray application of its effective and fast-working formula. Dr. Smithâ&#x20AC;&#x2122;s Diaper Rash Spray is an innovation in the treatment of diaper rash.
o %S 4NJUIlT %JBQFS 3BTI 4QSBZ XBT EFTJHOFE XJUI TBGFUZ and ease of use in mind. o 5IF QBUFOU QFOEJOH GPSNVMBUJPO FOTVSFT UIBU UIF QSPEVDU DMJOHT to the skin creating an even layer of protection when sprayed. o 5IF QSPEVDU TQSBZT PO FBTJMZ UP DSFBUF B NPJTUVSF CBSSJFS UP treat diaper rash and protect even the most sensitive skin from wetness. o 0ODF JUlT TQSBZFE PO UIF BGGFDUFE BSFB UIFSFlT OP OFFE UP SVC it in â&#x20AC;&#x201C; just spray it, leave it, and let it work. o 5IF GPSNVMB XPOlU DBLF PS SVO BOE UIF DPPMJOH TQSBZ IFMQT TPPUIF JSSJUBUFE CBCZ CPUUPNT
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Dr. Smithâ&#x20AC;&#x2122;s Diaper Rash Ointment and Spray products are available at retailers across the country including Target, Babies â&#x20AC;&#x153;Râ&#x20AC;? Us, buybuy BABY, Kroger, Walgreens, CVS, >HSTHY[ 9P[L (PK HUK V[OLY Ă&#x201E;UL YL[HPSLYZ
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Dr. Smithâ&#x20AC;&#x2122;s Diaper Rash Spray has parents talking.
â&#x20AC;&#x153;Dr. Smithâ&#x20AC;&#x2122;s Diaper Rash Spray is perfect for quick and complete coverage. Just a quick spray on red areas, and my sonâ&#x20AC;&#x2122;s rash was gone by the next diaper change.â&#x20AC;? â&#x20AC;&#x201C; Stepfanie, mom of four
â&#x20AC;&#x153;Having diaper rash ointment all over my Ă&#x201E;UNLYZ PZ UV[ [OL NYLH[LZ[ thing so the spray makes it no mess, no fuss, very easy.â&#x20AC;? â&#x20AC;&#x201C; Molly, mom of two
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Testimonials are non-paid. Individual results may vary. Copyright Š2015 Mission Pharmacal Company. All Rights Reserved. DSO-P155994
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DIAPER BY LISA MERRILL, MN, RN
(TO PREVENT DIAPER R ASH)
IMAGE CREDITS: 123RF
Use a c re a m ba r r ie r d ia pe a t eve r y r cha yo u r ba by nge if d ia pe deve lops r frequ ra s h e n t ly .
You’re so careful when it comes to protecting your baby’s skin, you: B Keep her little bottom clean and dry B Change her diaper after every feeding and when it’s wet or soiled B Use a protective barrier cream when rash is present B Wash your hands before and after every diaper change B Launder baby’s clothes separately with infantfriendly detergent B Bathe baby with gentle cleansers and pat—never rub—baby’s skin dry Yet that day comes when you look at your baby’s bottom and think, “Oh my goodness what IS that?” You’re not alone in wondering what the red bumps, blotches and blisters on your baby’s bum may be. Rashes—and managing rashes—are parents’ top infant skin care concerns, according to results from a Healthy Mom&Baby poll at Health4Mom.org. Thanks to newer, high-tech disposable diapers and disposable diaper inserts, experts say it’s possible to diaper to help prevent some forms of diaper rash, particularly contact dermatitis, which develops when baby’s skin reacts to urine or stool, or sometimes to ingredients in products you’re using on her skin or clothes, such as alcohol, dyes or perfumes. Even babyspecific products can cause reactions in some infants. Follow the advice in our ABCDE’s of diapering to prevent diaper rash and you’ll be well on your way to helping baby keep her bottom dry, clean and healthy. LISA MERRILL, MN, RN, is a clinical nurse specialist at Women ’s Hospital Health Sciences Center, in Winnipeg, Manitoba, Canada.
ABCDE’s
OF HEALTHY DIAPERING
Barrier
Air
Zinc-oxide diaper cream and petroleum jelly provide a barrier between baby ’s skin and the diaper containing urine or stool while your baby ’s skin heals. Use at every diaper change if your baby develops rash frequently, and speak to baby ’s healthcare provider about baby ’s reoccurring rash.
Allow baby ’s skin to air dry for as long as possible between changes and regularly give baby some diaper-free time.
Cleanse Always wipe gently and pat when cleaning baby ’s diaper area —never rub while cleansing baby ’s skin. Irritant-free wipes may actually be more effective than warm water when cleaning stool.
Use a super-absorbent disposable diaper or wrappers with absorbent inserts; the diaper should have a soft breathable outer shell or cover. Change your baby ’s diaper as soon as it ’s soiled or at least every 1-3 hours during the day, and once during the night.
Education Take note when and how your baby experiences diaper rash and ask your nurses for their advice on preventing diaper rash for your baby.
Diaper
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Learn more about diaper rash in our new Parent Pages, online at http://www. health4mom.org/ parents-page/.
Healthy Mom&Baby
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WHAT I WISH I ’D KNOWN ABOUT
Alcohol & Pregnancy BY K ATHLEEN TAVENNER MITCHELL, MHS, LCADC
“Your daughter has full-blown fetal alcohol syndrome.” Those words hit me like a tsunami. I was drowning in waves of grief, disbelief, horror and remorse. For 15 years, I searched to understand why Karli wasn’t learning and growing stronger, like my other 2 children. Doctors told me ear infections had caused her minor delays, but she would “grow out of it.” Today, Karli is 42 years old; developmentally, she is about 6 years old.
SKathy Mitchell with her daughter, Karli Schrider
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IMAGES: 123RF
I grew up in the 1960s in an upper middle-class suburban neighborhood. My charismatic father suffered with alcoholism, and my co-dependent mom worked hard to cover his tracks. At 16, I was already experimenting with alcohol and other drugs when I got pregnant, married and dropped out of school. I wanted to have a healthy baby so I gave up all of the drugs and drank apple wine on the weekends.
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healthy babies EFFECTS OF ALCOHOL IN PREGNANCY My 1st child, a boy, was born with a clubbed foot, which the doctor told me was a genetic disorder. I had Karli a year later, when the research describing fetal alcohol syndrome (FAS) was published. A few years later, I gave birth to another daughter and still had never been told not to drink during pregnancy. I divorced my high school sweetheart and remarried another man who liked to drink. My own issues with alcoholism and addiction spiraled out of control. I had 2 unplanned pregnancies while on methadone to treat my heroin addiction. No one at the clinic ever mentioned that it wasn’t OK to drink. My 2nd son came prematurely and died the day he was born. After a full-term pregnancy with my 3rd baby girl, I found her breathless in her crib at 10 weeks old: Sudden Infant Death Syndrome (SIDS). I didn’t realize how those years of addiction affected each of my children. NO SAFE AMOUNT OF ALCOHOL Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy. Most people with FASD don’t have intellectual disabilities, but do have attention deficits, behavioral issues, learning
disabilities, mental health issues, and problems with memory, judgment and reason. Each person can be affected in different ways and, often, a person with an FASD has a mix of these problems. FAS is the most severe form of FASD. Alcohol is a leading cause of fetal brain damage, birth defects and both fetal and infant death, including SIDS. While pregnant, there is no safe amount of alcohol, no safe time to drink alcohol, and no safe type of alcohol. Clean and sober for the last 31 years, I have dedicated my life’s work to increasing awareness and improving services for individuals with FASD and for women dealing with addiction issues. I have a beautiful marriage and 5 wonderful grandchildren. I went on to receive my Master of Human Services (MHS) degree and became a licensed clinical alcohol and drug counselor (LCADC). I know that treatment works, and by encouraging women to get help, we save their children too. Now I am that good mother I always wanted to be. If you’re struggling or think your child may be affected by FASD, don’t hesitate to reach out to your nurse, midwife or other healthcare provider. There is no shame in asking for help—your child’s life depends on it.
SKathy (far right) with daughters Karli (far left) and Erin Schrider (center)
B
FETAL ALCOHOL SYNDROME DISORDER (FASD) X FASD effects are lifelong —but they ’re also preventable X Alcohol in pregnancy is more harmful than any other recreational drug, including cocaine, heroin and marijuana SKathy with daughters Erin and Karli Schrider
X Alcohol can damage a developing baby before you even know you ’re pregnant X FASD is rarely diagnosed, making it an invisible disorder
KATHLEEN TAVENNER MITCHELL, MHS, LCADC, is vice
Source: NOFAS.org
president, National Organization on Fetal Alcohol Syndrome (NOFAS). Find help and support at Circle of Hope (www.nofas.org/circleofhope).
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OUR MISSION TO WIPE OUT
Diaper Need BY SUMMER HUNT
Food, water, shelter—these are all basic needs. For babies, there’s another item that tops that list: diapers. In the US, there are 5.3 million children ages 3 or younger living in poor or low-income families. Shockingly, there are no state or federal safety nets that help families purchase diapers. As a result, 1 in 3 families experiences “diaper need,” the struggle to buy and have enough clean diapers for their youngest children. When a baby doesn’t have enough diapers, all sorts of problems and choices arise. They might be exposed to health risks from being left in a dirty diaper too long. Without a full day’s supply of diapers, babies can be turned away from childcare and early education centers, forcing mom or dad out of work or school. Fortunately, there are organizations that do exist to help families overcome diaper need: The National Diaper Bank
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Network (NDBN) works with more than 230 community-based diaper banks across the country to both help families with diapers and other diapering essentials. In 2014, the NDBN distributed more than 35 million free diapers to more than 1 million babies. This year, Healthy Mom&Baby is partnering with the NDBN to raise awareness and to share the names, voices and stories of the families in every community who are struggling to provide for their youngest children. As we spoke with moms affected by diaper need each one shared a similar truth: This small gesture—donating diapers, or dollars for diapers to families in need in your community—might not seem like much, but it can mean the world when you’re struggling to take care of your family.
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healthy babies “I think there are a lot of misconceptions about people who get help from the diaper bank. We work very hard to make ends meet … I go without a lot of things to make sure my kids are taken care of. ” Lacey Cotton, mom to Alexis, Jerrod & Aurin
Choosing Between Diapers and Gas Lacey gave birth to her youngest son 6 weeks earlier than planned. “We knew that we would have certain expenses with the baby, but then having to bump all those payments up… we weren’t quite prepared,” she says. With her baby now 10 months old, Lacey is working long hours to support him and her 6-year-old son while her boyfriend takes care of the kids at home. “I use my car for work, and there are some days when it feels like a toss-up: Do I spend $30 on gas or $30 on diapers?” Lacey first came in contact with her local diaper bank through her church, which frequently donates diapers. “It’s so important to give back to your community, to pull together and support one another—especially where women and children are concerned,” she says. “You never know when something is going to come along, and a family might need just a little more help. Getting support from the diaper bank has made a huge difference for my family.” Lacey’s young son also has sensitive skin, which means she has to be careful about which diapers she uses and how frequently she changes him. “Knowing that I have enough diapers, and that I won’t have to leave him in a dirty one too long, risking him getting a rash, is such a relief,” she says. “I just want my kids to be happy and healthy.” Lacey and Aurin Photo by Rachel Wilson/RWilsonImages.com ISSUE 18 / Fall 2015 Healthy Mom&Baby
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1 in 3 Babies
Don’t Have the Diapers They Need
You Can Change That!
Healthy Mom&Baby Drive To Wipe Out Diaper Need When babies don ’t have enough diapers: y They can ’t go to childcare y Mom or dad can ’t go to work
COMIN THIS G FALL
You can ’t buy diapers with food stamps. Childcare and laundromats won ’t allow cloth diapers. It ’s a vicious cycle. You can help change this! Join with AWHONN nurses in your community this September during National Diaper Awareness Week by donating diapers or dollars for diapers as we work in partnership with the nonprofit National Diaper Bank Network to benefit families where you live. Together, nurses and families can help wipe out diaper need. Get involved at Health4Mom.org/diaper-drive.
wipe out diaper need
FOUNDING SPONSOR NATIONAL DIAPER BANK NETWORK
Donate Diapers for Families In Your Community Join the diaper drive Health4Mom.org/ diaper-drive
www.health4mom.org/diaper-drive Diaper Drive.rev1.indd 1
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Finding Hope and Paying It Forward
“Knowing I have diapers for my children means one less thing to worry about. It takes some of the stress away, and I know that there ’s hope out there. ” Venessa Baez, mom to Jean Carlos, Raul & Nathalie
When Venessa Baez’s second son was a baby, she knew something wasn’t quite right with his eating. “He was always spitting food up, and he couldn’t really consume it properly,” she says. Diagnosed with pancreatic divisum, Venessa’s son had to be a on a feeding tube to help with his chronic pancreatitis. Already living paycheck to paycheck, Venessa was dismayed to learn that her Medicaid benefits would not be enough to help her shoulder the weight of the mounting medical costs. Venessa found support from an Early Head Start Home Base Program. “A nurse would visit me every single week, bringing me diapers,” she explains. “I also received diapers from an organization called Welcome Baby, and I saw these stickers that said ‘Diaper Bank of North Carolina.’ These groups, with people just giving out of the goodness of their hearts… they’re truly godsends.” There were definitely moments when times got tough, Venessa recalls. “I would be exhausted, and I didn’t want to do the home visit, but I stuck with it,” she says. “And the Early Head Start Program changed my life: They believed in me and helped me get a job with Durham Connects, where I’m able to help moms and give back to the community that was there for me when I needed it. It’s a ripple effect.”
Venessa and Raul
Being Great Parents, No Matter the Circumstances Natasha Rivera-LaButhie was overjoyed to learn she was expecting—then her doctor delivered the news that she was actually pregnant with triplets. “We were prepared for one child,” she says, “but finding out it was multiples? Say what? Needless to say, my husband and I knew there would be a lot more costs coming our way.” Additionally, Natasha did not qualify for her employer’s medical benefits as a new hire; she received state medical insurance instead. Before entering her 3rd trimester, Natasha lost one of the babies and began having medical complications, becoming hospitalized for 75 days before giving birth. A hospital resource staff person encouraged Natasha to sign up for the diaper bank. Though she was initially hesitant about asking for help, bills were piling up. The twins’ daycare also required a full day’s supply of diapers, and she would have to leave work to bring more if they ran out. “I threw my pride out the window and signed up,” Natasha says. “It helps me to be a better parent. I have more time to tend to my kids’ needs, and I know they’re being taken care of.” Natasha’s local organization supported her with more than just diapers: “It was actually a church. I remember coming in there sometimes, feeling tired of my job, my bills… I felt like a bad parent because I couldn’t afford these basic necessities for my kids,” she says. “But people there didn’t judge me; they would welcome me with a smile and offer to pray for me and my family—it really meant a lot to have their encouragement and support.” These days, Natasha enjoys quality time playing outside and reading books with her family and working with the New Haven MOMS Partnership. “Sometimes I meet women who don’t want to ask for help,” she says. “To those moms I say, ‘Why would you not take advantage of a service that solely exists to help you take care of your family?’”
“I have a job to do as a parent, and that ’s make sure my children have what they need. ” Natasha Rivera-LaButhie, mom to Liana, Hailey & Angel (pictured above)
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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Creating The Help That's Needed Most
Â&#x201C;â&#x20AC;&#x153;A healthy supply of diapers keeps babies clean and dry, but it also reduces parent stressÂ&#x2026;â&#x20AC;Ś diapers help parents be able to further their education, as well as find stable housing and employment.Â&#x201D;â&#x20AC;? Rachel Alston, mom to Ayva & Hazel
This year, the nurses of AWHONN and families in communities including yours are working with the National Diaper Bank Network to launch Healthy Mom&Babyâ&#x20AC;&#x2122;s Drive to Wipe Out Diaper Need! Nurses are with moms when they first learn theyâ&#x20AC;&#x2122;re pregnant. Nurses give expert care and advice as moms go through prenatal visits. Nurses help moms birth the 4 million babies born in the US each year, and nurses are also known for collecting and donating diapers to local groups in their communities, including the diaper banks that support struggling families. Now, you can join with nurses to help families in need have enough diapers and wipes to properly care for their children: t 0SHBOJ[F B ESJWF EPOBUF EPMMBST GPS EJBQFST ZPVS EPMMBST XJMM CVZ diapers at wholesale!) t 5BLF B CJH CPY PG EJBQFST UP B EJBQFS CBOL JO ZPVS BSFB Then go online to DiaperDrive.org and tell us what you did so that we can count ZPVS FÄ&#x160; PSUT JO XJUI UIPTF GSPN "8)0// OVSTFT 5PHFUIFS XJUI PVS QBSUOFST at the National Diaper Bank Network we can Wipe Out Diaper Need.
W IPE OU T DI APER NE ED B 5.3 million infants and toddlers live in poor or
low-income families
B 1 in 3 American families donÂ&#x2019;â&#x20AC;&#x2122;t have enough
diapers
B $70-$80 is the typical monthly cost of disposable
diapers per baby
B Diapers costs triple when parents donÂ&#x2019;â&#x20AC;&#x2122;t have
transportation to Â&#x201C;â&#x20AC;&#x153;big boxÂ&#x201D;â&#x20AC;? stores
B Cloth diapers arenÂ&#x2019;â&#x20AC;&#x2122;t accepted at most
childcare centers
B A dayÂ&#x2019;â&#x20AC;&#x2122;s or weekÂ&#x2019;â&#x20AC;&#x2122;s worth of extra diapers is
typically required for each child in childcare
B You can't purchase diapers with foodstamps
DONATE AT DIAPERDRIVE.ORG SUMMER HUNT is editorial coordinator and writer for Healthy Mom&Baby.
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IMAGE CREDITS: 123RF, FAMILY IMAGES COURTESY OF THE INDIVIDUALS PIC TURED
Rachel and Ayva
Portland mom Rachel Alston found herself in a tight spot when she had her daughter, Ayva. Her husband was in school, and Rachel was staying at home with the baby. They already received assistance from other programs, but diapers were proving to be a pressing expense. â&#x20AC;&#x153;I donâ&#x20AC;&#x2122;t think I truly understood diaper need until I experienced it myself,â&#x20AC;? she says. â&#x20AC;&#x153;Iâ&#x20AC;&#x2122;ve also found that most people donâ&#x20AC;&#x2122;t know that there isnâ&#x20AC;&#x2122;t government assistance for families needing diapers.â&#x20AC;? Unfortunately, Rachel was not able to find a diaper bank in her area. â&#x20AC;&#x153;Eventually we turned to cloth diapering, because we were lucky enough to have a washer and dryer in our unit,â&#x20AC;? she says. â&#x20AC;&#x153;But I know that some families are just not in that situation, because theyâ&#x20AC;&#x2122;re in transitional housing or possibly even homeless, and most schools and daycares will not accept cloth diapering as an option.â&#x20AC;? Determined to help and hopefully decrease the number of moms in her position, Rachel founded PDX Diaper Bank, the first of its kind in Portland. â&#x20AC;&#x153;Thinking back on that time in my life, I remember being so stressed that I couldnâ&#x20AC;&#x2122;t provide this basic necessity for my child,â&#x20AC;? Rachel recalls. â&#x20AC;&#x153;Being a parent is challenging enough without having to count diapers or worry if youâ&#x20AC;&#x2122;re going to make it through the week.â&#x20AC;? As executive director of PDX Diaper Bank, Rachel meets families from all walks of life who experience that stress and worry. â&#x20AC;&#x153;Theyâ&#x20AC;&#x2122;re just trying to cope and survive day-to-day livingâ&#x20AC;&#x201D;overcoming homelessness, securing stable employment, battling health problemsâ&#x20AC;Ś all while trying to raise a child,â&#x20AC;? she says. â&#x20AC;&#x153;They are true everyday heroes.â&#x20AC;? If there was one thing Rachel could communicate to people considering donating to or even starting a diaper bank, it would be that there is such a great need, even if you donâ&#x20AC;&#x2122;t see it outright. â&#x20AC;&#x153;There arenâ&#x20AC;&#x2122;t enough diaper banks in the United States to completely close the diaper gap, but that is slowly changing as advocates educate communities about diaper need and the impact it has on families,â&#x20AC;? she says.
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Advertisement Feature
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Is bloated Has a hard belly Has increased flatulence Keeps squirming and pulling their legs up
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Filter Your Baby’s Environment BY K AITLYN DIXON
IMAGE CREDITS
When we think of creating a “green” environment for our baby, we often think of natural wood cribs, low-or no-VOC paints, and organic furnishings. However, filtering harmful substances and chemicals from your baby’s life is just as important as having a safe nursery.
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healthy babies LEAD Lead is a neurotoxin that can hurt your baby’s mental development and increase risks of miscarriage and birth defects, especially if you are exposed to lead during your first trimester. To avoid lead exposure, never eat non-food items like gravel or paint chips, even if you crave them during pregnancy (called pica). Avoid hobbies that involve lead, like car repair, ceramics, furniture refinishing, and art restoration. And avoid repairs or renovations on homes built before 1978, which may contain lead dust from paint and other materials. A simple way to further reduce exposure is to remove your shoes when you enter your house, so you don’t bring in the pollutants you collect outside.
When you’re pregnant or breastfeeding, you’re giving your baby the important nutrients she needs to thrive. You’re also introducing her environment, good and bad. And those exposures through you and your breastmilk and her home during her early development can influence her lifelong health. Here are some of the most common and wellresearched exposures to avoid to give baby the greenest start possible.
IMAGE CREDITS: 123RF
TOBACCO SMOKE Smoking during pregnancy can lead to stillbirth, premature birth, and an increased risk of SIDS, asthma, and learning disabilities for your baby. If you’re smoking and pregnant, quit now—there are many resources to help you. If you live with someone who smokes, ask them to only smoke out of the house so you can breathe clean air for your developing baby. This is equally as important during and after your pregnancy, especially in baby’s home and nursery. MERCURY Eating fish can give you and your baby brainboosting nutrients like DHA and omega-3 fatty acids, but avoid fish high in mercury like shark, swordfish, king mackerel, and tilefish. Mercury is a neurotoxin that can hurt your baby’s brain development, and mercury consumed during pregnancy concentrates in your developing baby, giving her an even greater exposure than you get as the mom. The EPA recommends that pregnant and breastfeeding women eat fish twice per week and choose low mercury fish like salmon, shrimp, and tilapia.
PESTICIDES Exposure to pesticides during pregnancy is associated with a higher risk of complications and birth defects. Risky exposures include spraying for insects in your house or weeds in your garden, or living near farming areas with heavy pesticide use. Don’t apply any pesticides in your home during pregnancy, especially during the 1st trimester. Clean up food and cover garbage to prevent pest problems, and if they still happen, try baits and traps instead of sprays. Even with these precautions, you will still bring pesticides home from the grocery store on your food. Consider buying organic, and wash all your produce carefully. To better wash off pesticides, use 1 part vinegar and 4 parts water to soak produce, then rinse thoroughly in running water. ENDOCRINE-DISRUPTING CHEMICALS Be careful of your exposure to endocrine-disrupting chemicals. These chemicals mimic hormones and can cause problems with thyroid and brain development, and the fertility and hormones of your developing baby. Some of the common chemicals to watch out for are BPA and phthalates, both commonly found in plastics. To reduce your exposure, eat less prepackaged and canned food, buy more fresh or frozen produce and buy organic, if possible. Avoid using plastics in your food preparation and storage. Chemicals accumulate in household dust, so use a vacuum with a HEPA filter to get rid of those contaminants. Another source of phthalates is cosmetics, so look for natural care products with short lists of ingredients that you recognize.
Buy Produce Organic When Possible The Environmental Working Group provides these lists of foods with the highest and lowest concentrations of pesticides: The Dirty Dozen B Apples B Celery B Cherry tomatoes B Cucumbers B Grapes B Nectarines B Peaches B Potatoes B Snap peas B Spinach, kale & collard greens B Strawberries B Bell Peppers & Hot Peppers The Clean 15 B Asparagus B Avocados B Cabbage B Cantaloupe B Cauliflower B Eggplant B Grapefruit B Kiwi B Mangoes B Onions B Papayas B Pineapples B Sweet corn B Sweet peas B Sweet Potatoes
KAITLYN DIXON is a public health educator who writes for Healthy Mom&Baby
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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Unique & personalized gifts for your baby’s special moments
At Pearhead, we aim to create unique, quality products that celebrate those special moments in life. Everything we design is based on simplicity and functionality, while maintaining an aesthetic that complements home décor trends, which is specifically how our Babyprints photo frame was created. This classic white wooden frame proudly displays your baby’s handprint and footprint along with an adorable photo. It is simply the easiest way to capture your baby’s prints. Just press your baby’s hand or foot onto the included “Clean-Touch” ink pad to reveal a detailed print. To make parents life easier, we created a completely mess free ink pad where the baby’s foot and hand never touches the ink. Everything in there is included for you to create the perfect memento: beveled mat stamped in silver with “My Little Prints”, ink pad and cardboard. This frame is the perfect gift, the perfect keepsake to cherish for years to come. Available at BabiesRUs - http://bit.ly/1MDS2lX
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See all Teethers in the Baby Collection at www.ChewyQ.com or call us at #207-741-2443. Babies love Chewy Q’s!
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healthy babies
Tooth or Consequences BY SUMMER HUNT
CAN YOU RAISE A CAVITY-FREE CHILD? While you may bristle at the idea of getting into the dentist’s chair, twiceyearly checkups don’t have to get your child down in the mouth. Debra Glassman, DDS, of Glassman Dental Care in New York City emphasizes prevention is key. “Start early and instill good habits. When parents set good examples, it promotes oral health for the family,” she says. Start young on the path to be cavity free for life.
IMAGE CREDITS: 123RF
TOOTH BASICS FOR BABIES Dental health is important for all ages—including little ones whose tooth buds are still encased in their gums! “Rub a xylitol-containing gel on your baby’s gums to kill cavity-causing bacteria,” says Glassman. “Massaging the gums feels good for baby and stimulates blood flow.” Clean baby’s gums after each feeding. Prevent tooth decay—and skip the choking hazard—by never putting your older baby down with a bottle for nighttime or naps, or substituting a bottle for a pacifier. “Milk or food remnants feed bacteria in the mouth, leading to decay,” says Glassman. Cavities can be catching, too: “Never clean baby’s pacifier by putting it in your own mouth—this just transfers bacteria,” she advises. Instead, keep bottled water on hand for quick rinses. HEALTHY TODDLER TEETH Baby teeth begin to emerge around 4-6 months, with all 20 appearing by the time your child is 3 years old. Many parents typically meet with a pediatric dentist when those 1st teeth appear. Getting them into the dental chair early, meeting the dentist and having a positive experience goes a long way toward good oral health. Even though your child will lose her baby teeth, they still require proper care. “Without good oral hygiene, teeth can decay and fall out early, causing crowding,” explains Glassman. “Healthy baby teeth lead to healthy permanent teeth.” Even as baby teeth begin to cut through, use a soft, cold brush to ease teething; once they’re fully in, floss! Many pediatric dentists now also recommend sealants for extra protection against decay.
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Food as Floss BEYOND BABY TEETH Most kiddos begin to get their permanent teeth around age 6 and have nearly all of them—except their wisdom teeth—by age 13. “Children and adults should visit the dentist every 6 months, or twice a year,” says Glassman. Brushing twice and flossing once a day is vital, but she also recommends brushing after every meal, as possible. If you don’t have easy access to your brush, bottled water is your friend: “Simply sip, swish and swallow to get any residue off your teeth.”
Avoid sugary snacks and simple carbohydrates to maintain a healthy mouth as they break down quickly into glucose, feeding the bacteria that cause cavities. “Potato chips can be just as harmful as licorice! Fruits and veggies are great, as well as cheese; it ’s soft to chew and gently scrubs away plaque, ” says Dr. Glassman.
SUMMER HUNT is the editorial coordinator and writer for Healthy Mom&Baby.
Oral Care in Pregnancy Before your baby is ever born, it ’s important to protect your oral health as poor hygiene has been linked to low birthweight, preterm birth and preeclampsia. Talk to your healthcare provider about any dental procedures you may need in pregnancy, and always brush gently, as your gums may be tender and more susceptible to bleeding.
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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healthy pregnancy
Parenting FREE RANGE
IMAGE CREDITS: 123RF
BY NOTOYA GREEN
My triplets are 4½ and will soon be going to kindergarten. I try to them give them as much freedom as possible without putting them at risk. Freedom to learn and explore is beneficial. It builds confidence while they learn about the world around them. Helicopter parenting can cause our kids to miss important milestones like learning how to dress themselves, look at a book on their own, etc. When my kids are at a park I let them play on their own unless they need my help. I give them the freedom to walk ahead of me down the street, as long as they remain in view and away from the road. I am not a fan of letting young kids travel alone; your kids need your supervision, even if from a distance, and most importantly they need your protection. Freedom, though, isn’t always about roaming. It’s also thinking for themselves and making choices, like choosing their own clothes or activities. At restaurants, I let them choose and make their own order. They know to say “excuse me” to get the waiter. They’re learning to interact with others of all ages. I gave my kids a lot of freedom as soon as they could explore our cabinets and drawers as part of their play. I made sure there was nothing dangerous or unsafe in those spaces. I also did my best not to
KEEP YOUR CHILD SAFE AS THEY GROW OLDER
say “no” all the time because exploring and discovery is essential toddler behavior. FREE RANGE PARENTING TODDLERS You can begin free range parenting when your kids begin to crawl. Of course, your child needs a safe environment, but it’s a good idea to give them space to roam and explore when they can crawl, cruise and walk. Encourage their curiosity. Follow them and watch them explore something that’s not necessarily a toy, like a remote control. Our goal should be to give our kids freedom, otherwise we hinder their learning. We base how much freedom we give them on their age and development. Watch for signs that your child wants more independence. Some 2-year-olds want to dress themselves—let them even if it takes longer. Some 3-year-olds want to choose their own clothes— encourage them to do so as long as they’re appropriate. Give your kids the space and supervision to achieve important milestones.
Soon, your toddler will be a kindergartener; teach them how to stay safe apart from you: 1. Seek a mother with children. Teach your child to seek the nearest mother with kids if they feel unsafe. Statistically, she ’s the most likely person to help them. 2. Empower your children. Give them permission to be rude to an adult if they feel threatened or unsafe.
NOTOYA GREEN is a family law attorney at the Administration for Children ’s Services and mother of 4-year-old triplets in Tribeca, NYC.
3. Adults never ask children for help. Teach them to run away if an adult approaches your child asking for help, especially if it involves going to a different location.
ISSUE 18 / Fall 2015 Healthy Mom&Baby
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