“Are They Real Contractions?” Drink a Glass of Wine!

Toward the end of your pregnancy, you may experience Braxton Hicks contractions, which feel like real labor pains but do not signify the onset of labor. There are various ways to tell if they are the real deal or not, but if you call your doctor or midwife in a panic, they make this suggestion: Relax, and have a glass of wine. If the contractions are real, they’ll intensify, but if they are Braxton Hicks, they will likely go away very soon after.

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But is it safe for the baby?

Drinking an occasional glass of wine during pregnancy has been a controversial topic. Obviously, frequent or heavy drinking is dangerous for your baby, but a glass of wine here and there is where opinions differ. Some maintain that the effects of alcohol on a fetus are still unknown and it’s better to avoid alcoholic beverages altogether. Others (like most Europeans!) believe that there’s nothing wrong with an occasional drink and indulge themselves without giving it a second thought.

Regardless of where you stand on the issue, one glass of wine toward the end of your pregnancy probably doesn’t pose any hazard to your baby’s health. And if it stops the Braxton Hicks and puts your mind at ease, it’s an added bonus! L’Chayim!

Drink some water too…

Being dehydrated can bring on false labor pains as well. So in addition to your glass of wine, be sure to drink plenty of water, which may help ease Braxton Hicks as well!

Postpartum Danger Signs to Watch For

The weeks after your baby is born are full of wonder and worry. You may feel all sorts of conflicting emotions and uncomfortable physical sensations. Most of these physical and mental states are all within normal range, but sometimes there are complications. Call your health care provider right away if you experience any of these warning signs:

  • Depression: You feel extreme sadness or despair,  have delusions or thoughts of harming yourself or your baby.
  • Bleeding: Your bleeding isn’t tapering off, continues to be bright red after the first four days, resumes after slowing down, contains clots bigger than a quarter, or has a foul odor.
  • Fever: You develop a fever, even a slight one. A low-grade fever may be something benign, but it can also be a sign of a serious infection, so play it safe and call.
  • Stomach pain: You have severe or persistent pain anywhere in your abdomen or pelvis, or  afterpains that get worse instead of better.
  • C-section pain: You have worsening pain or soreness that persists beyond the first few weeks, or redness, swelling, or discharge at the site of your c-section incision.
  • Vaginal pain: You have severe or worsening pain in your vagina or perineum, foul-smelling vaginal discharge, or swelling or discharge from the site of an episiotomy or a tear.
  • Breast pain: You have pain or tenderness in one area of the breast that’s not relieved by warm soaks and nursing. Or you have swelling or redness in one area, possibly accompanied by flu-like symptoms or fever.
  • Abnormal urination: You have pain or burning when urinating; you have the urge to pee frequently but not a lot comes out; your urine is dark and scanty or bloody; or you have any combination of these symptoms. (Stinging after the urine comes out and hits a bruised or torn area normal.)
  • Leg pain: You have severe or persistent pain or tenderness and warmth in one area of your leg, or one leg is more swollen than the other.
  • Headaches: You have severe or persistent headaches.
  • Vision problems: You have double vision, blurring or dimming of vision, or flashing spots or lights.
  • Vomiting: You have severe or persistent vomiting.
  • Tenderness from IV: The site of your IV insertion becomes painful, tender, or inflamed.

When to call 911 (or local emergency number) instead:

  • You have shortness of breath or chest pain, or are coughing up blood.
  • You’re bleeding profusely.
  • You’re showing signs of shock, including light-headedness, weakness, rapid heartbeat or palpitations, rapid or shallow breathing, clammy skin, restlessness or confusion.

For more Postpartum information, visit Baby Center

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Contractions: Are These the Real Thing?

During the third trimester, some women experience “false” contractions called Braxton-Hicks contractions. This is a normal occurrence, and like real labor contractions, they may increase in frequency and intensity, making you worry that you are going into premature labor. But unlike true labor, these contractions don’t grow consistently longer, stronger, and closer together.

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image from Women Health Tips

How to tell if it’s preterm labor: True labor contractions show a definite pattern. Employ the 1-5-1 formula: if your contractions last at least one minute, are five minutes (or less) apart, and continue for at least one hour you are, most likely, in labor. (This would mean you should alert your health-care provider immediately.) Braxton-Hicks contractions come and go and don’t settle into a regular pattern. Don’t forget to practice relaxing and breathing with these trial-run contractions. (Dr. Sears)

If you are within a few weeks of your due date, but the Braxton Hicks contractions are making you uncomfortable, try these measures:

  • Change your activity or position. If you’ve been sitting or laying down, try walking around. If you’re been  moving a lot, resting may provide relief. (On the other hand, true labor contractions will progress regardless of what you do.)
  • Take a warm bath to help your body relax.
  • Drink water; these contractions are sometimes brought on by dehydration.
  • Relaxation exercises and slow, deep breathing may help you cope with the discomfort.

Should I call the doctor?

If you haven’t reached 37 weeks yet, and are having more than four contractions in an hour, or contractions are becoming more frequent, rhythmic, or painful, call your caregiver immediately.  In this case, it’s better to play it safe and don’t try to make the diagnosis yourself. Preterm labor is not something to take chances with. Other possible signs of preterm labor:

  • Abdominal pain, menstrual-like cramping, or more than four contractions in an hour (even if they don’t hurt)
  • Any vaginal bleeding or spotting
  • An increase in vaginal discharge or a change in the type of discharge — if it becomes watery, mucusy, or bloody (even if it’s only pink or blood-tinged)
  • Increased pelvic pressure (a feeling that your baby’s pushing down)
  • Low back pain, especially if it’s a new problem for you

Umbilical Hernia during Pregnancy

During pregnancy,  you can usually expect your belly button to flatten out and protrude somewhat more than usual. But sometimes this protruding navel is actually an “umbilical hernia,” a condition that is rarely serious and usually resolves on its own after birth.

What Causes an Umbilical Hernia:

Dr. Gerard M. DiLea, obstetrician-gynecologist and author of The Anxious Parents’ Guide to Pregnancy, explains (BabyZone) that to some extent, everyone has an umbilical hernia! As a fetus develops, there’s a hole in the main supporting layer of the abdomen, allowing the blood vessels of the umbilical cord to go in and out. This small opening sometimes remains after birth. For some people the opening can become larger due to increased abdominal pressure (like a chronic cough or, in our case, pregnancy.) Part of the small intestine passes through this hole causing a hernia.

Symptoms of an Umbilical Hernia

Tenderness around your belly button, especially during coughing or after straining (lifting and carrying around your toddler, for example), may indicate that you have an umbilical hernia.  Sometimes you can feel or see a protrusion right near the belly button that you can actually push back in.

Will I Need Surgery?

In most cases, an umbilical hernia does not need surgery. But sometimes a complication called incarceration develops, where organ tissues or intestines are trapped, cutting off their blood supply. The hernia will be painful. When this happens, a hernia surgery is required to repair the damage. If you suspect that your hernia is causing strangulation, you should see your doctor immediately, because if not corrected, an incarcerated hernia is very dangerous. Look out for symptoms such as swelling, pain, or discoloration.

The surgery is usually done as an outpatient procedure, under general anesthesia, and is a low-risk operation.

feature photo from health.com

Pregnancy Warning Signs You Should Never Ignore

Aches and pains, weird skin conditions, fatigue and mood swings are all part of a normal pregnancy. But sometimes you  may experience something that could be a potentially serious warning sign.  Most women don’t want to bother their doctor over every tiny thing, so how do you know what warrants immediate attention and what can wait until your next doctor’s visit?

WebMD consulted the experts, who say you’re always better safe than sorry. If you are concerned that something is not normal, call your doctor. And every pregnant woman should be aware that there are some symptoms during pregnancy that need immediate attention.

WebMD presents the seven top signs of a potentially serious pregnancy complication:

1. Bleeding During Any Trimester

Bleeding during pregnancy is serious and always needs to be evaluated immediately. Call your doctor or go to the emergency room. Some serious causes for bleeding include:

First trimester: Heavy bleeding, severe abdominal pain, menstrual-like cramps, and feeling like you might faint could be a sign of an ectopic pregnancy. This happens when a fertilized egg implants somewhere other than the uterus, and it can be life-threatening.

First and second trimester: Heavy bleeding with cramping could also be a sign of miscarriage.

Third trimester: Bleeding and abdominal pain may indicate placental abruption, which occurs when the placenta separates from the uterine lining.

2. Severe Nausea and Vomiting

If it gets to the point where you can’t keep anything down, you are at risk of becoming dehydrated and malnourished, which can cause serious complications ranging from birth defects to premature labor.  Proper nutrition is very important for you and your baby.  Your doctors can prescribe safe medications for controlling nausea, and may also advise some dietary changes to help you find food you can keep down.

3. Baby’s Activity Level Decreases Significantly

What does it mean if your previously active baby is not moving as much as it used to?  It is possible that he is not getting enough oxygen and nutrients from the placenta.  To find out if there really is a problem, eat something or take a cold drink. Then lie on your side to see if this gets the baby moving.

You can also count kicks, although “There is no optimal or critical number of movements.” As a general guideline, you should count at least 10 kicks in two hours. Anything less, call your doctor as soon as possible.

4. Early Contractions

Contractions could indicate preterm labor. First-time mothers may be confused by real labor and Braxton-Hicks contractions, which are false labor pains.  Braxton-Hicks are unpredictable and do not increase in intensity. They generally subside in an hour, with activity, or after drinking. On the other hand, regular contractions start off about 10 minutes apart, and over time increase in intensity while becoming closer together.

If you are feeling contractions and don’t know what they are, don’t take a chance! If it is too early for the baby to be born, your doctor has ways to stop labor.

5. Your Water Breaks

Sometimes water breaking is a dramatic gush of liquid, but other times it’s just a subtle trickle.  Then again, it could be urine leakage due to increased pressure on your bladder. One way to tell is to go to the bathroom and empty your bladder. If the fluid keeps coming , then your water has broken… time to call your doctor or go to the hospital!

6. Severe Headache, Abdominal Pain, Visual Disturbances, and Swelling

These are all symptoms of preeclampsia, a serious and potentially fatal condition. Other signs of preeclampsia are high blood pressure and excess protein in your urine. It usually occurs after the 20th week of pregnancy.  You need to call your doctor and get your blood pressure tested. With good prenatal care, you can catch and treat preeclampsia early.

7. Flu Symptoms

Pregnancy puts added stress on the immune system, so pregnant women are more likely to catch the flu when it’s going around. They are also at a higher risk for more serious flu complications.

Flu symptoms include fever, cough, sore throat, runny nose, sneezing, nausea, diarrhea, and vomiting. If you think you’ve got the flu, call your doctor first instead of rushing into his office where you could spread it to other pregnant women.

Something else to be aware of is that a fever greater than 101.4 degrees could indicate an infection. So even if you don’t have the flu, you should call your doctor so he can evaluate your condition.

For more information on health and pregnancy, visit WebMD

feature image from US Moms Today

Endometriosis and Fertility

Endometriosis is one of the most common health problems for women, often associated with pain and infertility, yet is often misdiagnosed.  It gets its name from the word endometrium, the tissue that lines the uterus or womb. Endometriosis occurs when this tissue grows outside of the uterus on other organs or structures in the body, most commonly on the:

  • Ovaries
  • Fallopian tubes
  • Tissues that hold the uterus in place
  • Outer surface of the uterus
  • Lining of the pelvic cavity

According to the Endometriosis Research Center: “It is more prevalent than breast cancer, yet continues to be treated as an insignificant, obscure ailment… The average delay in diagnosis is a startling 9 years, and a woman will go through as many as 5 physicians before she is properly diagnosed and treated.”

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Symptoms:

The most common symptom is pain in the lower abdomen (pelvis) or the lower back, mainly during menstrual periods. The amount of pain is different for each woman, and does not depend on how much endometriosis she has.

Other symptoms of endometriosis can include:

  • Very painful menstrual cramps, which may get worse over time
  • Chronic pain in the lower back and pelvis
  • Pain during or after sex
  • Intestinal pain
  • Painful bowel movements or urination during menstrual periods
  • Spotting or bleeding between menstrual periods
  • Infertility or not being able to get pregnant
  • Fatigue
  • Diarrhea, constipation, bloating, or nausea, especially during menstrual periods
  • Click here for other related health problems

The symptoms of endometriosis diminish during pregnancy. Symptoms also tend to decrease with menopause, when menstrual periods end for good.

Associated health problems

Endometriosis growths are benign (not cancerous), but they still can cause many problems. To understand why, it helps to be familiar with a woman’s menstrual cycle. Every month, hormones cause the lining of a woman’s uterus to build up with tissue and blood vessels. If a woman does not get pregnant, the uterus sheds this tissue and blood through the vagina, IE: as her menstrual period.

Patches of endometriosis also respond to the hormones produced during the menstrual cycle. But misplaced endometriosis tissue and the cells it sheds have no way of leaving the body. Trapped between layers of tissue, they cause inflammation, scar tissue, adhesions and bowel problems. These growths expand over time, adding extra tissue and blood. This is why the symptoms of endometriosis often get worse.

As endometrial tissue grows, it can cover or grow into the ovaries and block the fallopian tubes. Trapped blood in the ovaries can form cysts, or closed sacs. It also can cause inflammation and cause the body to form scar tissue and adhesions (tissue that sometimes binds organs together). This scar tissue may cause pelvic pain and make it hard for women to get pregnant. The growths can also cause problems in the intestines and bladder.

Can I reduce my chances of getting endometriosis?

Because the hormone estrogen is involved in thickening the lining of the uterus during the menstrual cycle, you can try to lower the estrogen levels in your body.

  • Exercise regularly
  • Keep a low amount of body fat
  • Avoid large amounts of alcohol and caffeine
  • Try to keep stress levels as low as possible
  • Balance estrogen levels naturally. Read more here.

Testing

Pelvic exam. Your doctor will perform a pelvic exam to feel for large cysts or scars behind your uterus. Smaller areas of endometriosis are hard to feel.

Ultrasound. Your doctor could perform an ultrasound, an imaging test to see if there are ovarian cysts from endometriosis. During a vaginal ultrasound, the doctor will insert a wand-shaped scanner into your vagina. During an ultrasound of your pelvis, a scanner is moved across your abdomen. Both tests use sound waves to make pictures of your reproductive organs. Magnetic resonance imaging (MRI) is another common imaging test that can produce a picture of the inside of your body.

Laparoscopy. The only way for your doctor to know for sure that you have endometriosis is to look inside your abdomen to see endometriosis tissue. He or she can do this through a minor surgery called laparoscopy. You will receive general anesthesia before the surgery. Then, your abdomen is expanded with a gas to make it easy to see your organs. A tiny cut is made in your abdomen and a thin tube with a light is placed inside to see growths from endometriosis. Sometimes doctors can diagnose endometriosis just by seeing the growths. Other times, they need to take a small sample of tissue and study it under a microscope.

HSG. Women with endometriosis who are struggling to get pregnant can undergo a structural study known as an HSG (hysterosalpingogram). This diagnostic test can be performed in as little as five minutes. The procedure is associated with cramping, but ibuprofen can be used to ease the pain. During the test, radiocontrast media is injected through the cervix into the uterus. An x-ray is taken to examine the internal contour of the uterus and check whether the fallopian tubes are open.

Treatment

Conventional medicine states that there is no cure for endometriosis, but there are many treatments offered to deal with the pain and infertility.  A naturopathic/integrative medicine doctor will suggest a different course of action to clear up endometriosis based on diet, exercise, detox, addressing emotional stress, and/or natural progesterone.

Pain Medication. For women with mild symptoms, doctors may suggest taking over-the-counter medicines for pain. These include ibuprofen (Advil and Motrin) or naproxen (Aleve).

Hormone Treatment. When pain medicine is not enough, doctors often recommend hormone medicines to treat endometriosis. Only women who do not wish to become pregnant can use these drugs. Hormone treatment is best for women with small growths who do not have bad pain. Hormones come in many forms including pills, shots, and nasal sprays. Common hormones used for endometriosis include:

  • Birth control pills to decrease the amount of menstrual flow and prevent overgrowth of tissue that lines the uterus. Most birth control pills contain two hormones, estrogen and progestin. Once a woman stops taking them, she can get pregnant again. Stopping these pills will cause the symptoms of endometriosis to return.
  • GnRH agonists and antagonists greatly reduce the amount of estrogen in a woman’s body, which stops the menstrual cycle. These drugs should not be used alone because they can cause side effects similar to those during menopause, such as hot flashes, bone loss, and vaginal dryness. Taking a low dose of progestin or estrogen along with these drugs can protect against these side effects. When a woman stops taking this medicine, monthly periods and the ability to get pregnant return. She also might stay free of the problems of endometriosis for months or years afterward.
  • Progestins. The hormone progestin can shrink spots of endometriosis by working against the effects of estrogen on the tissue. It will stop a woman’s menstrual periods, but can cause irregular vaginal bleeding. Medroxyprogesterone (muh-DROKS-ee-proh-JESS-tur-ohn) (Depo-Provera) is a common progestin taken as a shot. Side effects of progestin can include weight gain, depressed mood, and decreased bone growth.
  • Danazol (DAY-nuh-zawl) is a weak male hormone that lowers the levels of estrogen and progesterone in a woman’s body. This stops a woman’s period or makes it come less often. It is not often the first choice for treatment due to its side effects, such as oily skin, weight gain, tiredness, smaller breasts, and facial hair growth. It does not prevent pregnancy and can harm a baby growing in the uterus. It also cannot be used with other hormones, such as birth control pills.

Surgery. Women with severe endometriosis — many growths, a great deal of pain, or fertility problems — may consider surgery. Your doctor might suggest one of the following:

  • Laparoscopy can be used to diagnose and treat endometriosis. During this surgery, doctors remove growths and scar tissue or burn them away. The goal is to treat the endometriosis without harming the healthy tissue around it. Women recover from laparoscopy much faster than from major abdominal surgery.
  • Laparotomy  or major abdominal surgery that involves a much larger cut in the abdomen than with laparoscopy. This allows the doctor to reach and remove growths of endometriosis in the pelvis or abdomen.
  • Hysterectomy is a surgery in which the doctor removes the uterus. Removing the ovaries as well can help ensure that endometriosis will not return. This is done when the endometriosis has severely damaged these organs. A woman cannot get pregnant after this surgery, so it should only be considered as a last resort.

The Natural Path. Carolyn Dean, M.D., N.D. states: “While modern medicine insists the cause of endometriosis is unknown and there is no cure, it can be relatively simple to treat and control the symptoms. The standard medical treatment involves taking synthetic hormones, such as the birth control pill, that stops menstruation and therefore stops the buildup of blood and endometrial tissue outside the uterus. But there are new ways of approaching endometriosis that are much kinder to the body and address an underlying problem that certainly relates to the condition.” To learn about turning the tables on endometriosis using alternative methods, click here or here, or speak to a naturalistic doctor for more information.

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Emotional Support

You may want to consider joining a support group (online or in your community) to talk with other women who have endometriosis.

You can find out more about endometriosis by contacting womenshealth.gov at 1-800-994-9662. You also can contact the following organizations:

Endometriosis Association
Phone Number(s): (414) 355-2200
Internet Address: http://www.endometriosisassn.org

The American College of Obstetricians and Gynecologists
Phone Number(s): (202) 638-5577; (202) 863-2518 (for publication requests only)
Internet Address: http://www.acog.org

Endometriosis Research Center
Phone Number(s): (561) 274-7442
Internet Address: http://www.endocenter.org

Eunice Kennedy Shriver National Institute of Child Health and Human Development
Phone Number(s): 1-800-370-2943
TTY: 1-888-320-6942
Internet Address: http://www.nichd.nih.gov

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Treating Ear Infections: Forgo the Antibiotics

Contrary to what we’ve been told up to now, antibiotics may not be the best medicine for your child’s ear infection!  A recent study in the British Medical Journal has shown that treating with antibiotics can actually increase the chances of relapse!  So what is the best medicine? Possibly no medicine at all!

CBS News reports that more than 75 percent of kids before the age of 5 have an ear infection, according to the Journal of the American Academy of Pediatrics. Ear infections have routinely been treated with antibiotics, but now, new research suggests the best medicine may be no medicine at all.  There is substantial evidence to show that about 80 percent of ear infections clear up without antibiotics, and with no ill effects.

What you may not have known is that most ear infections are caused by viruses, which are not treatable with antibiotics anyway.”  Everyone involved may have to work on their patience, but letting the ear infection run its course may be your best option.

The American Academy of Pediatrics is about to update its guidelines. The new “rules” will say that unless the child is very young or very sick, a doctor should employ “watchful waiting” — monitoring the child’s health. Your doctor might prescribe a safety net antibiotic prescription (SNAP) to be filled only if the child has not improved within 48 to 72 hours.

However, current guidelines suggest that some children should still get antibiotics:

• Are under age 2
• Appear seriously ill with fever of 102F or higher
• Have fluid dripping from the ears
• Have a double ear infection (both ears infected)

If you still don’t believe your child’s ear infection will heal best on its own, you should be aware of some side effects caused by antibiotic. The most serious side effect, she said, is antibiotic resistance.  In about 10 to 20 percent of children, Ashton said, antibiotics can cause upset stomach, vomiting, diarrhea. Less frequently, they can cause rashes.

You want to avoid over-use of antibiotics to avoid antibiotic resistance, which makes the next bug tougher to treat. The next time your doctor prescribes amoxicillin, the most common one for kids, it might not work. Doctors would be wise to head this new research, but in 84 percent of cases, they still prescribe antibiotics.  It may be up to  parents to decide that antibiotics may not be the best medicine, and forgo.

“Pediatricians are now focusing on pain relief,” CBS News Medical Correspondent Dr. Jennifer Ashton said. “Children screaming in pain will not get relief from an antibiotic in the first 24 hours. They should be given ibuprofen (Advil) or acetaminophen (Tylenol), and sometimes prescription ear drops can ease the pain.”

**Side Note: I only had one experiences with ear infections when my daughter was a baby, a few years ago. The doctor gave me a choice of antibiotics or a homeopathic remedy. I decided to try the homeopathic remedy, and it worked wonderfully. The ear infection may have gone away on it’s own, but the pain subsided very quickly and gave us no more problems!

10 Ways to Relieve Labor Pains

Well, really in my opinion there is only one way, and it works like magic. It’s called an epidural. Ok, just kidding (but not really)!!  However, if you are looking for drug-free ways to relieve labor pains, there are many techniques out there, and many women have had exhilarating (if not completely pain-free–sorry!) natural births. Lamaze.org offers these 10 tips to staying within your “comfort zone.”

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1. Find a Soothing Environment

Your birth setting must feel safe to you. It should have space to walk and bathe, as well as a variety of options to enhance movement, comfort, and pain relief: a soft bed, CD player, rocking chair, birth ball, low stool, and/or squatting bar. It should also have policies that encourage you to try a variety of positions. Access to appropriate medical care is crucial if problems arise.

2. Choose Your Team Carefully

Knowledgeable, caring midwives, doctors, nurses, partners, loved ones and/or doulas create a supportive birth team. When you’re treated with respect and patience, stress and inhibitions decrease, and you can more easily find your best coping mechanisms.

3. Learn About Labor

The more knowledge you have, the fewer surprises you will experience. Find out everything you can about labor from books, magazines, Web sites, videos, classes, a hospital tour and discussions with your health-care provider, doula, family and friends. Familiarize yourself with the procedures and customs at your hospital or birth center. Such discussions are best had before labor.

4. Express Your Fears

Are you worried about pain and labor, needles, medicines or losing control? Speak with a knowledgeable and trusted friend, childbirth educator or doula. Voicing your concerns can bring relief as well as practical solutions to your concerns. Stating your preferences in a birth plan can also help calm fears.

5. Practice Rhythmic Breating

Breathe fully in a slow rhythm during contractions. Release tension with each exhalation and try moaning. Also try taking quick breaths, about one every 2 to 3 seconds (20 to 30 per minute). Your partner or birth coach may be able to help you keep your rhythm with eye contact, rhythmic hand or head movements, or by talking you through contractions.

6. Use Imagery and Visualization

Focusing on something that makes you happy (like your partner’s face, an inspirational picture or favorite object) engages your senses and decreases your awareness of pain. Listen to music, a soothing voice or a recording of ocean waves, and imagine yourself in a relaxing environment.

7. Take a Warm Shower or Bath

A warm shower is soothing, especially if you can sit on a stool and direct a handheld showerhead onto your abdomen or back. Bathing in warm water is relaxing, and it may even speed up labor.

8. Keep Moving

Move around as much as you can. Walk, lean, sway, rock and squat. Some positions will be more comfortable than others.

9. Seek Relief with Warm or Cool Compresses

Place a warm pack on your lower abdomen, groin, lower back or shoulders during labor. A cold pack or latex glove filled with ice chips can soothe painful areas. Cool cloths relieve a sweaty face, chest or neck.

10. Indulge in Gentle Touch or Massage

Have your partner or doula massage you in whatever way provides the most relief for you.  Whether it’s someone holding your hand, stroking your cheek or hair, or patting your hand or shoulder, touch conveys reassurance, caring and understanding.

To Circumcise or Not to Circumcise

If you have a little boy on the way, you have probably thought about whether to have the foreskin on your son’s penis removed, or leave it intact. With both “pros” and “cons” to consider, some new parents may be confused about this decision. In the end, it’s a family’s personal choice. However, here are some things to consider.

Dr. George Steinhardt, a urologist at Helen DeVos Children’s Hospital in Grand Rapids, Michigan, says the biggest reasons American parents choose to circumcise their boys are still religious and cultural. “I think it’s done primarily for cultural reasons,” he explains.

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photo by Proud to Introduce

The Medical Perspective
Medical professionals today debate whether or not the procedure is medically necessary. Dr. Mark Reiss, a retired physician and executive vice president of the nonprofit organization, Doctors Opposing Circumcision, believes that there is no medical reason to circumcise.  “The penis is meant to be covered by the foreskin. The normal state is intact. The U.S. is the only country in the world that performs routine circumcisions.”

Yet, other experts point that there are valid reasons to consider the procedure. Among them are the following:

Infections: Dr. Anthony Chin, a Los Angeles-based obstetrician, points out that circumcision does make it easier to keep the penis clean, and decreases the chances of infection.  “Let’s face it, boys aren’t the cleanest of genders,” he points out!  Today, however, we have antibiotics to treat infections, making them less dangerous than they were in the past. “Before antibiotics, people got really sick, but now in the post antibiotic era, circumcisions are not ‘medically’ necessary anymore.”

Kindney Problems: “We see a lot of babies with kidney problems,” notes Steinhardt. “For those boys, I would recommend that a circumcision be done. It protects against the possibility of an infection.”  In particular, when his patients are diagnosed with fetal hydronephrosis, or dilated kidneys (which is more common in boys than girls) he almost always believes that circumcision is necessary to alleviate the risk of infection and other complications.

Sexually Transmitted Disease: Steinhardt believes that circumcision may have other serious benefits. “There’s valid scientific evidence that HIV is more likely in a man with foreskin than in a man without foreskin.” Steinhardt also says that you rarely see cancer of the penis in a man who has been circumcised.  However, other experts say there is not evidence that circumcision prevents any STD’s or cancers.

Appearance
Chin notes that circumcisions are basically for cosmetic purposes now, saying that sometimes an uncircumcised child decides to have the procedure done later in life.  In the US, women seem to prefer a circumcized penis, and there are plenty of teenagers who get  circumcised for cosmetic reasons.

Ease
A 5-minute procedure as an infant is easier than the same procedure on an adolescent or adult.  Barbara Dehn, RN, MS, NP, a practicing nurse who teaches at Stanford University, says if you opt to circumcise, do it soon after birth. “The key with circumcision,” she says, “is that if you decide to do it, don’t wait too long. Even when they’re 3, that’s probably too late, since the experience will be too traumatic for them.”

Pain Control
Those who oppose circumcision often call it as a barbaric procedure that leaves infants in terrible pain.  The issue of pain and cruelty is often one of parents’ biggest concerns. Will he feel the incision? Will there be a long, difficult recovery? Will there be complications?

The claim that circumcision causes tremendous pain is simply not true, says Steinhardt. “In general, it’s a pretty harmless procedure. It’s well tolerated, it’s done with great care, and complications are rare and few and far between.”  Plus, with proper pain control, many babies just sleep right through the procedure. “You can have confidence that it can be done safely.” If you are concerned, have a conversation with whoever will be doing the procedure, whether the pediatrician, OB/GYN, or mohel, about what measures can be taken for pain control. A local anesthetic can be used to ensure a painless circumcision.

For more info:

TheCradle: Circumcision: What you need to know

Dr. Sears: Frequently Asked Questions about Circumcision

New Mothers: Common Breastfeeding Problems

For something that’s supposed to “come naturally,” there is a lot of discomfort and confusion surrounding the whole process of breastfeeding. New mothers are surprised at the pain and frustration that often accompanies the experience, which is generally made to look easy and pleasurable for both mother and baby.

Several problems common to breast-feeding mothers can be prevented or eased through simple techniques or addressed with common, simple treatment options. The following conditions, and the advice offered, are from true star health:

Sore nipples

Most women will experience some degree of nipple soreness in the first days of breast-feeding. Discomfort that occurs at the onset of breast-feeding and is relieved by feeding is normal. It is caused by the stimulation of the nipple by the hormone oxytocin, which stimulates milk let-down. True nipple soreness, in which the nipples appear red and are tender to the touch, is probably caused by the baby’s improper grasp on the nipple and areola (pigmented area surrounding the nipple) while feeding.

Proper latching: Correcting the baby’s position on the breast is the most important tactic for preventing and relieving sore nipples. A physician, nurse, or lactation consultant can assist in assessing and correcting an infant’s grasp of the nipple. Sore nipples can progress to more painful, cracked, and fissured nipples. As the condition worsens, the nipples are more susceptible to infection. In addition to correcting the baby’s position, there are a number of self-help measures frequently recommended for the relief of sore nipples. These are most effective when begun at the onset of symptoms.

Change positions: Check the position of the baby on the breast; the infant’s tongue should be under the nipple and the mouth should grasp both the nipple and part of the areola. Vary the position of the breast-feeding infant with each feeding to avoid soreness of a particular area of the nipple.

For more information on proper latching and positioning, see Dr. Sears advice on Sore Nipples.

Feed frequently: The infant should be fed on demand; an overly hungry infant may suck harder, causing nipple soreness. Mothers with sore nipples should begin each feeding on the side that is least sore, switching to the sore breast after the let-down reflex has occurred. The infant should not be allowed to suck on an empty breast, which can cause damage to the nipple. If the nipples are sore, a breast-feeding session of ten minutes on each side should be sufficient to nourish the baby.

Ice packs applied to the breasts prior to breast-feeding can have a pain-relieving effect. Applying your own breast milk to your nipples after nursing, and allowing them to air-dry can help to reduce nipple soreness.

Apply ointment: In the case of cracked nipples, the application of an ointment or cream can aid healing. Ointments or creams allow the skin’s internal moisture to heal deep cracks and fissures while keeping the skin pliable. A frequently recommended and safe ointment for cracked nipples is medical grade, purified anhydrous lanolin (derived from wool fat). The nipples should be patted dry prior to application of a small amount of lanolin.

Engorgement

Engorgement is a common condition that occurs as blood and lymphatic flow to the breasts greatly increases, leading to congestion and discomfort. The pain associated with engorgement can range from mild to severe. Engorgement typically occurs on the first full day of milk production and lasts only about 24 hours. The breasts may feel firm and hot to the touch and the skin may appear reddened. As with other conditions, the best remedy is prevention.

Feed frequently: Many health professionals believe frequent breast-feeding (at least every three hours) will successfully prevent engorgement. This is probably true for most women. However, the physical changes associated with initiation of breast-feeding may eventually lead to engorgement in some women. If engorgement occurs, the best remedy is to breast-feed frequently. This can relieve the engorgement and prevent the condition from worsening.

Applying heat and cold: Doctors often recommend additional options for women with engorgement. A well-fitted bra can relieve some of the discomfort of engorgement. Applications of moist heat may encourage flow of milk from the breasts. Women may apply hot packs to the breasts just prior to breast-feeding. Other suggestions include frequent warm showers or alternating hot and cold showers. Cold packs applied to the breasts after breast-feeding can provide a slight pain-relieving effect.

Express excess milk: Some infants will have a difficult time correctly latching on to an engorged breast. This can lead to inadequate nourishment and sore nipples. Expressing some excess milk, manually or with a pump, just prior to breast-feeding may relieve this difficulty. Women may also express milk after the infant has finished feeding to relieve any remaining sense of fullness. Massaging the breasts while breast-feeding may encourage milk flow from all the milk ducts and help to relieve engorgement.

Mastitis

Mastitis is inflammation of the breast that is frequently caused by an infection. The infected breast may feel hot and swollen. The breast may be tender to the touch, and fever, fatigue, chills, headache, and nausea may be present. Some women feel as though they have the flu. A breast infection requires prompt medical attention. Complete bed rest is important for a speedy recovery, and antibiotics are frequently prescribed. In addition, doctors often provide further guidelines for treating mastitis.

A woman should continue breast-feeding from both breasts; the milk from the infected breast is still good for the baby. Moist heat over the painful breast can be helpful, and cold applications after breast-feeding can help alleviate swelling and pain. Breast-feeding women should also avoid constricting or under-wire bras that may irritate the infected breast.

Other issues you might be facing include flat or inverted nipples, Candida (yeast infection), plugged milk ducts, breast abscess, babies who fight against breastfeeding, babies that bite, and colicky babies. I suggest Dr. Sears’ Breastfeeding Guide for information, advice, tips and treatment options.

Image from mylifetime.com

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