Fertility Blog

Sore Nipple Strategies

2019-08-17T22:50:34+00:00August 17th, 2019|Categories: Fertility Blog|Tags: , , , |

.Most of us had an idea in our head about how breastfeeding would go. You probably pictured the serene moments gazing into each other’s eyes, then your milk drunk baby slipping off to sleep in your arms.  The reality of the early days of breastfeeding can be surprising, as those of us that have lived them can attest. For 80-90% of moms, nipple and breast pain is part of their new mom life, at least in the short term since almost all nipple pain resolves in the first 2 weeks.

Nipple pain it’s not just for new moms, it can re-emerge with each baby. Issues like a shallow latch, slow let-down and tongue tie are unique to each baby. Although your breastfeeding experience will help you solve these problems much faster the second time around.

If you are suffering from nipple pain, here is a list of possible reasons and solutions:

-Shallow latch. You baby should have a wide open mouth before latching onto the nipple and surrounding areola, not just the nipple. Top and bottom lips should both be curled back and the chin firmly pressed on the breast. This position allows the nose to remain unobstructed with correct positioning.

– Pulling your baby off before breaking suction. When you are ready to take your baby off the breast, place a finger in the side of the mouth to release the suction first. Otherwise you stretch and strain tender nipple tissue.

-Slow milk flow. Your baby may be spending extra time on your breast or try to suck with greater force if your let-down reflex takes a while. To speed it up, self express a bit of milk before feeding to get milk flowing and soften up your breast before latching your baby. Once your baby is on the breast, use breast compression to keep milk flowing quickly without much suction from your baby.

-Using the same breastfeeding position every time. Depending on the angle, you baby’s mouth can apply pressure in different parts of your breast and nipple. If you have a tender spot when using the football hold, try lying on your side next time you feed.

-Dry, cracked nipple tissue. Your nipple has natural lubrication from the oils released by your Montgomery Glands, the little bumps that surround your areola. But the friction of your baby’s mouth can strip away your natural oils leaving your nipples red and cracked. There are several nipple creams available that can help your tender tissue heal. Check out our Milkies Nipple Nurture Balm  for an organic olive oil based cream that doesn’t need to be removed prior to putting your baby to breast.

Your nipple pain should taper off and go away entirely by day 14. If your nipple pain lasts longer or is accompanied by other breastfeeding problems like full breasts or a frequently fussy baby, see your lactation consultant.

 

Breast Anatomy Beyond the Nipple

2019-07-18T13:29:10+00:00July 18th, 2019|Categories: Fertility Blog|Tags: , , , , |

The internal structures of breasts were first described in 1840 by Sir Astley Cooper. And since then, our knowledge of breasts has changed to include many more than Cooper could have visualized. He described the breast being composed of glandular and adipose (fat) tissue held together by a loose framework of fibers he called Cooper’s ligaments (of course). Cooper’s ligaments support the structure of our breasts and are blamed for stretching during pregnancy and breastfeeding, leading to sagging. If you are interested, there are several exercises that claim to strengthen Cooper’s ligaments. I reviewed them and it appears they work the pectoral muscles (push ups, chest flys and chest press) which lay under your breasts. Working out your pectoral muscles helps your posture but is unlikely to have an impact on the connective tissue inside the breast.

 

Beyond the ligaments, the inside of a breast is an amazingly complicated structure. Surrounding the nipple like daisy petals are 15 to 20 sections, or lobes. Inside these lobes are smaller sections, called lobules that are arranged in clusters, like grape bunches. At the end of each lobule are tiny “bulbs” that produce milk. The bulbs are called alveoli and that’s where the magic of milk production occurs. From the alveoli,your milk enters the ducts, the thin tubes that carry the milk from the lobules to the nipple. When the milk-ejection reflex occurs, small muscles around the alveoli are squeezing the milk out into the lobules to the ducts and out of the nipples.

 

Imagine a stalk of broccoli and the tiny flower bits are the alveoli, the stem is the ducts which carry the milk to the nipple. Fat fills the spaces between the lobes and ducts. Actually, most of our breast volume is fat. When you shop for a bra, your cup size is mostly determined by how much fat you have between your connective tissue. That’s why your cup size has no relation to your ability to breastfeed. Smaller breasts (A to C cups) can be easier for babies to latch on, especially in the first days of life.

 

Working our way out of the breast, the last stop is the nipple. The nipple is in the center of a dark area of skin called the areola. The areola contains small glands that lubricate the nipple during breastfeeding. The bumps on the perimeter of your nipple are glands called Montgomery glands. They constantly secret oil to keep your areola and nipple healthy and moisturized. Montgomery glands also secret your unique scent that attracts your baby to the nipple and helps initiate breastfeeding. We have 12-14 openings in each nipple, and they can spray in any direction as anyone that his squirted milk in unpredictable directions knows.

 

Breastfeeding and Your Period

2019-07-04T01:06:03+00:00June 23rd, 2019|Categories: Education, Fertility Blog|

Can nursing get any better? Let’s list the ways it simplifies mom life: no equipment, no prep, always ready and available. Need one more reason to breastfeed? How about a break from your period. That’s right – no Aunt Flo or Ladies Days for up to a year!

The pause in menstruation means that you are not ovulating again and are very unlikely to get pregnant until your period restarts. This pause in your period is known as lactational amenorrhea. When used as birth control it’s called the Lactational Amenorrhea Method, or LAM.  Research shows LAM is more than 98% effective at preventing pregnancy as long as you are exclusively breastfeeding, your baby is younger than 6 months of age, and your periods have not restarted.

If you nurse frequently, your menstrual cycle and ovulation is most likely going to be suppressed. That means every 4 hours or less during the day and every 6 hours or less overnight. Every mom is different. I didn’t have a period for more than a year with both of my exclusively breastfed babies. I had friends that told me their period came back in 1-2 months and they were breastfeeding too. The research supports this – some exclusively breastfeeding moms start having periods within the first few months of nursing. Others whose babies sleep for long durations and have supplemental feedings will not have a period for twelve months or longer. Some women go as long as two years or more without menstruating after the initial flow of lochia (vaginal bleeding for 2 to 4 weeks after birth) has stopped.

Most moms will notice some light bleeding or spotting before having a regular period. And if your period came on schedule before pregnancy, your monthly visitor might surprise you and just drop in anytime. Expect your period to be irregular and variable in flow and length.  Any bleeding is a sign your body is ready to be fertile again and you should start using contraception (unless you are ready to be pregnant again of course!). A “warning period” is a common term to describe the first signs menstruation and fertility are returning. A delightfully ominous term I think!

It is possible for a nursing mom to become pregnant while she is breastfeeding and before she has her first menstrual period. But this is very unlikely since the shedding of the uterine lining is the beginning of the cycle. When your warning period arrives, or even better before it arrives, it’s time to start thinking about using contraception. Birth control pills or any other hormonal method can have a negative effect on your milk supply. Use condoms or another barrier method.

Post Partum Preeclampsia – Signs and Symptoms

2019-05-31T14:46:44+00:00May 31st, 2019|Categories: Fertility Blog|

The road to motherhood is different for each of us. Every mother and baby takes their own path through pregnancy, delivery and beyond. Our bodies are able to grow our babies, nourished and protected from the world until, for some unknown reason, labor begins. In the overwhelming majority of pregnancies and deliveries, all goes well. Most moms are worn out, exhausted and wearing their oh-so-soothing ice diaper in the early post-partum period. But within days, they start feeling better, breastfeeding gets easier and moms find their stride.

For a small number of new moms, they don’t start feeling better. Post partum complications are rare but they happen and they can be dangerous. Most of us don’t see our doctor for 6 weeks after birth and complications can set in much earlier. One of the most common birth complications is post partum preeclampsia. Postpartum preeclampsia occurs when you have high blood pressure and excess protein in your urine soon after childbirth. Preeclampsia is a similar condition that develops during pregnancy, and it typically resolves with the birth of the baby. Most cases of postpartum preeclampsia develop within 48 hours of childbirth. However, postpartum preeclampsia sometimes develops up to six weeks or later after childbirth. This is known as late postpartum preeclampsia.

The cause of pre-eclampsia and late postpartum eclampsia is not well understood. One theory  is based on an imbalance between the blood supply demands of the uterus, placenta and fetus during pregnancy. This can cause damage to the cells and change the way our blood vessels expand and contract. Our blood pressure and regulation is a delicate balance of fluid regulation (by the kidneys) and blood vessel dilation or relaxation depending on the demands of the body.

Researchers are aware of some factors that place moms at higher risk for post partum preeclampsia:

  • High blood pressure during your most recent pregnancy. You’re at increased risk of postpartum preeclampsia if you developed high blood pressure after 20 weeks of pregnancy (gestational hypertension).
  • Obesity. The risk of postpartum preeclampsia is higher if you’re obese.
  • Having multiples. Having twins, triplets or more increases your risk of preeclampsia.
  • Chronic high blood pressure. Having uncontrolled high blood pressure before pregnancy increases your risk of preeclampsia and postpartum preeclampsia.
  • Diabetes. Having type 1 or type 2 diabetes increases your risk of preeclampsia and postpartum preeclampsia.

These are risk factors of many pregnancy complications but be aware of the of common symptoms of post partum preeclampsia. New moms that are busy caring for a newborn may not be thinking about their own health, but if you have a headache that won’t go away call your doctor or have your blood pressure taken. If you don’t have a blood pressure cuff at home, you can go to your closest fire department and they will take it there for you. If the bottom number is over 90, you have high blood pressure. For example 150/100. Other symptoms of post partum preeclampsia are: swollen ankles, cough and shortness of breath and changes in vision. Postpartum preeclampsia requires prompt treatment so go the hospital right away. Left untreated, postpartum preeclampsia can cause seizures, fluid in the lungs, damage to liver, lungs and other serious health problems. If you have any risk factors, be sure to have frequent check-ins with your doctor after your baby is born.

Soothing Strategies for Teething

2019-05-20T12:37:58+00:00May 20th, 2019|Categories: Fertility Blog|Tags: , , , , |

Our babies are born with all their teeth just waiting to pop through their little pink gums – although pearly whites usually don’t peak through until about 6 months of age. You might notice the first signs of teething as small bumps on the bottom jaw in the center front. These bumps are the teeth trying to break through the tough gum tissue – which can take a few days to weeks. Your baby will continue to get new teeth until all 20 have come in, usually by age 3.

 

With 20 teeth breaking through those little pink gums, teething can cause some serious discomfort. If your baby is in the age range and showing any of these signs, teething may be to blame:

  • Fussiness
  • Trouble sleeping
  • Irritability
  • Loss of appetite
  • Drooling more than usual

Your baby may have sore or tender gums when teeth begin to break through the gums. Some babies like to have their gums rubbed with a clean finger, a cool spoon, or a moist washcloth. A clean teether for your child to chew on may also help. Look for teethers made of solid rubber, and avoid liquid-filled teething rings or plastic objects that could break.

I made my own teether at home using a washcloth. You can too, just wet the washcloth, tie it into a knot and freeze it. The hard knot will give your baby a solid surface to chew and the cool temperature will reduce inflammation and pain.

New recommendations from the FDA urges us to stick with teethers for pain relief and avoid products that numb the gums for kids younger than 2. In a statement from the FDA, “We are also warning that benzocaine oral drug products should only be used in adults and children 2 years and older if they contain certain warnings on the drug label,” the FDA said in a May 2018 statement. “These products carry serious risks and provide little to no benefits for treating oral pain, including sore gums in infants due to teething.” Benzocaine is an over-the-counter anesthetic, which the FDA notes are usually under the product names Anbesol, Hurricaine, Orajel, Baby Orajel and Orabase. Benzocaine has been associated with a rare but serious—and sometimes fatal—condition called methemoglobinemia, a disorder in which the amount of oxygen carried through the blood is greatly reduced.

Many parents like to use amber teething jewelry for babies to mouth and chew. Check frequently for fraying or weakness in the string and throw away any items that are at risk from breaks. The small pieces of amber can be a choking hazard.

Teething is a time when babies (continue to) put everything in their mouth. Help them sooth by having appropriate items handy for them. The items will be dropped frequently, so dishwasher safe is a plus. Some babies eschew all items and prefer to chew on their fist, this is convenient because it won’t be left behind or forgotten but your baby can develop a rash on his hand from the saliva. Try to wash his hand frequently and offer other items if you see a rash develop.

 

Get More Sleep Strategies For Moms

2019-04-29T11:50:56+00:00April 29th, 2019|Categories: Fertility Blog|

New parents are usually the more exhausted people in any room, caring for a baby is a 24/7 job. Getting more sleep is the goal of most new parents so methods like sleep training can look like the answer. The term “sleep training” is a loaded one. Most parents associate the idea with sitting on the floor, outside the nursery listening to your baby cry and scream themselves to sleep, leaving everyone traumatized and exhausted. A new wave of sleep experts say sleep training is more about teaching your baby that they are capable of falling asleep independently – but you decide. Every parent needs to choose the best way of managing sleep for their family. Some parents do fine on a few hours of sleep, others need more to have the patience to care for a baby. There are many factors to consider when caring for your baby.

Ideally, you want your baby to be able to fall asleep without you since they will inevitably wake at night and look for you to provide the same song, rocking, breast that helped them fall asleep the first time. But the best way to accomplish this isn’t clear and as with all things parenting, there are no rules. Even the “sleep experts” don’t agree on the best way to help babies sleep longer. Or if we should want them to. I mean of course we want to sleep longer, but for breastfed babies with small tummies that empty quickly, frequent nursing sessions through the night can keep your milk supply strong and help your baby get the nutrition they need to grow.

One thing the experts agree on to help your baby fall asleep is a consistent bedtime routine. Around six weeks old, pick the same time every evening to bathe, sing, read and feed your baby then place her into her crib. Consistent wake up times help too.

If you choose sleep training it should start between four and six months, according to some experts. There are many methods of sleep training, all involving some form of allowing your baby to cry and fuss without any soothing. Sleep training is not recommended by many lactation consultants, babies cry for many reasons and responding to your baby’s cries given them confidence in you and the safety of their environment.

Instead of sleep training, here are some tips for instilling good sleep habits early on:

  • Offer the breast frequently during the day. You want her to get the idea that the daytime is for eating and nighttime is for sleeping.
  • Wait to respond to nursery noises. It’s natural for a baby to wake up occasionally  during the night and they may fall back asleep without help from you. Wait outside the door to make sure your child needs soothing and not just whimpering in his sleep. If you go in the nursery, it may turn into a full-fledged wake up necessarily.
  • Aim for an early bedtime. An earlier bedtime—like 6:30pm or 7:00pm—may help your baby sleep longer. Putting your baby down earlier means less of a chance for them to be  overtired. Just like adults, overtired babies can find emotions get in the way, making the nighttime routine more difficult.
  • Open the blinds. Help your baby learn the difference between night and day by opening the blinds in the morning and going outside during the day. Try to keep the nighttime nursery environment quiet and dark. These cues help your baby learn the expectations and routines for night and day.

Sleep deprivation is definitely a real thing – and it can make us desperate for some rest. Try to sleep when your baby naps during the day, although this is tough if you also have older children. Be kind to yourself and focus on caring for yourself and you baby and ask for help if you need it!

 

The Rise of the Brelfie

2019-04-13T23:37:30+00:00April 13th, 2019|Categories: Fertility Blog|

I am a mom, so I take a lot of pictures. I have stopped apologizing and my family has stopped being surprised by my requests to “look this way” or “just pretend you like each other”. They now accept the only way to get me to stop bugging them is to do what I ask and let me take their picture.

 

When they were little babies, it was easier in some ways. More difficult in others. They would stay when I put them, arranged with good lighting. But they didn’t didn’t smile on demand or care about my desire to memorialize an event. My older son had a diaper blow-out at his 1 year old phone shoot so had to be creatively posed to cover his soiled parts.

 

So the brelfie trend is my favorite thing ever. Brelfie is a mash-up of breastfeeding + selfie. I admit, it’s an awkward word. But I love them, the babies are always content, moms look beautiful, empowered and proud. Plus, it’s fun to see all the amazing places women are breastfeeding and caring for their babies. Glamorous celebrelfies (I made a word!) helps us see that we have acres of common ground with Gisele, Chrissy and Pink. The wonder of motherhood catches us all flat-footed and unprepared. We are proud of our bodies and our babies – regardless if there is dirty laundry or designer goods in the background.

 

When I started Milkies way back in 2008, I was breastfeeding my son Henry and we modeled for the product photos. Check out the side of a Milkies Milk-Saver box for a pic of an 8 month old Henry latched on. There were no selfies in 2008 though, phones only had one camera! So your breastfeeding pictures had to be taken by someone else, hence there were fewer taken and available to share. Facebook stopped censoring breastfeeding pictures in 2014 so moms could share their brelfies without fear of banning.

 

The positive influence of the brelfie has even been recognized by the United Nations.“It’s absolutely to be encouraged,” World Health Organization spokeswoman Fadela Chaib told a regular U.N. briefing in Geneva when asked about the brelfie fad.’ https://uk.reuters.com/article/us-socialmedia-brelfies-idUKKCN10919R

 

Brelfies will always have critics and trolls. But, if you are a breastfeeding mom and want to support and encourage others, staying positive is the best way to go about it. A brelfie image shows you are proud of your choices and rocking this mom thing – so post away mommas.

The 2 images featured in this article are my brelfies.

Breastfeeding Just One Baby Can Prevent Strokes

2019-03-27T04:12:48+00:00March 27th, 2019|Categories: Fertility Blog|

Losing Luke Perry to a stroke was a shock. For those of us that grew up on Beverly Hills 90210, we are mourning a bit more for Dylan McKay and his sweetness and crooked grin. While stroke is usually considered a something that happens to older people, it can happen to anyone at any age. Women are more likely to suffer a stroke than men – in fact 55,000 more women than men will have a stroke this year. Birth control pills, pregnancy are risks for younger women, while hormone replacement therapy and high blood pressure are associated with risks for stroke later in life. A study published in the Journal of the American Heart Association in August 2018 found stroke is the fourth leading cause of death among in women 65 and older, and is the third leading cause of death among Hispanic and black women aged 65 and older.

Having a stroke can hugely complicate life for you and your family. After a stroke, many women will become disabled and unable to live independently, it is the most common cause of long-term disability and costs the economy $34 billion annually. We plan our retirement financially through 401K savings and funding Medicare – it is just as important to plan for a healthy, physically active retirement. Reducing stroke risk is important for both aspects, as medical costs can quickly wipe out savings accounts.

This 2018 study looked at breastfeeding and how it relates to the risk of stroke for moms. The researchers also collected information about the ethnic background of the moms and how it relates to stroke risk.

Researchers analyzed data on 80,191 participants in the Women’s Health Initiative observational study, a large ongoing national study that has tracked the medical events and health habits of postmenopausal women who were recruited between 1993 and 1998. All women in this analysis had delivered one or more children and 58 percent reported ever having breastfed. Among these women, 51 percent breastfed for one-six months, 22 percent for seven-12 months and 27 percent for 13 or more months. The average age of the women when they entered the study was 63.7 years; they were followed for 12.6 years.

The good news for breastfeeding moms – after adjusting for non-modifiable stroke risk factors (such as age and family history), researchers found stroke risk among women who breastfed their babies was on average:

23 percent lower in all women,

48 percent lower in black women,

32 percent lower in Hispanic women,

21 percent lower in white women, and

19 percent lower in women who had breastfed for up to six months.

This is really great news! The study results showed the longer you breastfed, the greater reduction in your risk for stroke. Breastfeeding for at least 6 months is recommended to get all the protective benefits from stroke, breast and reproductive cancers.

The more we learn about breastfeeding, the greater the value to our long term health for moms and babies!

Should We Pump and Dump After A Night Out?

2019-03-07T18:00:20+00:00March 7th, 2019|Categories: Fertility Blog|

I have a friend that brought a bottle of chardonnay right into the delivery room, packed in her hospital go bag. As soon as the cord was cut, the chilled wine flowed into mini red solo cups she packed just for this moment.  She and her husband wanted to celebrate the occasion in their own way and they just had the one small cup and didn’t overindulge. But she felt like she owned the moment and got to lift a glass (well plastic cup) in a toast to her new son and her motherhood journey.

Like my friend, about half of breastfeeding moms have a drink now and then. Since breastmilk is made by taking nutrients and fluid from your blood, some alcohol shows up in your milk. When you take a drink of wine or beer, the fluid travels to the stomach and then exits to the small intestine, where it is absorbed into your bloodstream. Your blood transports the alcohol to the liver, where enzymes break it down. Our liver can get rid of about 1 ounce of alcohol an hour. Any extra accumulates in the blood and body tissues until the liver can process it. This extra alcohol makes us feel tipsy and singing Journey’s “Don’t Stop Believin’” at the office Christmas party seems like the best idea ever (not me, happened to a friend…)

If you have a glass of wine or other adult beverage, the amount of alcohol that could pass through to your breast milk is very small. A review of 41 studies in the journal Basic & Clinical Pharmacology & Toxicology finds that even in a binge drinking scenario, if a mom breastfed, the blood alcohol of the infant would be less than .005%. The researchers concluded “It appears biologically implausible that occasional exposure to such amounts should be related to clinically meaningful effects to the nursing children.”  Still, the American Academy of Pediatrics recommends that women minimize alcohol consumption during lactation and if you drink, limit your intake to 2 ounces of liquor, 8 ounces of wine, or two 12-ounce beers.

You can safely have a few drinks without getting your baby drunk, but if you are concerned about your supply, stick to non-alcoholic beverages. Despite stories about beer and wine increasing milk supply, the research doesn’t support it. Studies have shown drinking alcohol while breastfeeding inhibits the milk ejection reflex, also known as the let-down (this reflex moves your milk from the lobes of your breasts to the nipple and out to your baby). For let-down to occur, the nerve connections from the nipple to the hypothalamus area of the brain need to be ready to receive the signal from your baby suckling at your breast to release oxytocin. Alcohol can deaden these signals and leave milk in your breasts and your baby frustrated. We know the milk product works on supply and demand; breasts need to be empty to signal your body to make more milk. If you are drinking alcohol regularly, this lack of intact nerves, hormone release and breast emptying results in a decrease in milk production of up to 23%. If you are stressed about your supply, avoid alcohol until you get back on track.

It also needs to be mentioned that anyone, including you, caring for your baby is required to be sober. Keeping a baby or toddler safe critical thinking and unclouded decision making; remember the Journey story from paragraph 2? You can make bad choices if you are drunk. Your children are counting on you to keep them safe.

If you co-sleep make alternative sleeping arrangements if you have been drinking. Alcohol can put you into a deeper sleep and this has been strongly linked to a higher risk of sudden infant death syndrome or accidental suffocation. Don’t drive if you have been drinking or get into a car with anyone else that has.

Just like pre-mom days, alcohol is fun occasionally but can easily lead to problems if used to excess. Feel free to have a drink now and then but deal with your mom stress in healthier ways.

Newborn baby sleeping in mother’s arms in hospital

The Smallest Victims of the Opioid Epidemic

2019-01-22T05:01:46+00:00January 22nd, 2019|Categories: Fertility Blog|

The opioid crisis has touched all of us; more than 2.5 million Americans are dealing with addiction to prescription or illicit opioids. The origins of the epidemic can be traced back to the late 1990s when pharmaceutical companies began to aggressively market drugs like Oxycodone to providers. Drug manufacturers reassured the medical community that their products weren’t addictive and were the best option for managing short term and chronic pain. As the number of prescriptions grew, it became clear that opioids could be highly addictive.

Now that we have looked back to the start of this public health crisis – where does that leave us today? According to a 2018 study by the CDC, the number of women with Opioid Use Disorder (OUD) at labor and delivery has quadrupled in 10 years.  Unfortunately, this isn’t surprising. Opioid use has grown in all demographics with the largest increase occurring in women. Pregnant women with OUD face numerous barriers to care – limited financial resources, access to treatment, stigma, and fear of legal consequences.

When a pregnant woman is addicted to opioids, she is likely to have a constant level of the drug in her blood and her baby is receiving a constant dose through the placenta.  When her baby is delivered, a drug withdrawal syndrome called Neonatal Abstinence Syndrome (NAS) begins.  A new study found that incidence of NAS is rising in the United States. There was a five-fold increase in the proportion of babies born with NAS from 2000 to 2012 —equivalent to one baby suffering from opiate withdrawal born every 25 minutes. Newborns with NAS are more likely than other babies to also have low birth-weight and respiratory complications. In 2012, newborns with NAS stayed in the hospital an average of 16.9 days, compared to 2.1 days for other newborns.

Research shows Medication Assisted Treatment (MAT) is the first-line recommendation for pregnant women with opioid use disorders. The goals of treatment are to manage withdrawal, reduce cravings, and prevent the feeling of getting “high”. Pregnant mothers receiving MAT are more likely to have prenatal care, better nutrition and have a higher birth-weight baby. MAT also helps to reduce illicit drug use and infections.

Researchers are learning more about moms and moms-to-be battling addiction. The more we know, the more we can help them with safe and effective treatment, helping them give their infants the very best start.

 

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