Make Time for Tummy Time

2019-11-11T05:53:38+00:00November 11th, 2019|Categories: Fertility Blog|Tags: , , , , , |

As our babies grow, they need new ways to exercise their bodies and brains. Sitting up, rolling over and putting random items in her mouth all make new connections in her brain and help her develop coordination. Making sure your baby has plenty of time out of her crib or car seat has many crucial benefits. Spending time playing on her stomach, aka Tummy Time, strengthens her neck and back muscles. Most importantly, tummy time can help your baby stay safe by reducing the risk of SIDS.

During Tummy Time your baby is lifting her head and using all the muscles in her upper body. Essentially doing a miniature baby plank. The ability to lift her head up can help your baby avoid rebreathing her air if she rolls on her stomach or gets into a tight spot. The saying “back to sleep, tummy to play” is a good way to remember to put your little one on her tummy when you or a caregiver is watching. Then always put your baby to sleep on her back without any pillows or blankets in the crib with her.

There are many reasons to let your baby play on her stomach as much as possible:

  1. Upper body strength for safety and repositioning (see above)
  2. Reduce the risk of positional plagiocephaly (flat spot on the head). Usually if a flat spot does develop, it will be on the back of the head from the pressure of her head being in contact with her crib or car seat for extended periods of time. Around 20% of babies have a flat spot on their head that resolves as they approach 1 year of age
  3. Tummy time helps your baby reach physical milestones on time since they are moving and using muscles in different ways
  4. Have an interesting toy within reach so your baby can practice moving her body, reaching and grasping

Safe tummy time tips:

  1. Tummy time should be after a nap or other time when your baby is wakeful.
  2. Carefully watch your baby, make sure she isn’t spitting up
  3. Wait 30-45 minutes after feeding to allow for digestion time
  4. Tummy time can be on your/dad’s/caregivers chest too
  5. Don’t give up if your baby gets cranky, start for 2-3 minutes at a time.

There are several other recommendations for safe sleep from the American Academy of Pediatrics. Read the full article here https://pediatrics.aappublications.org/content/138/5/e20162940#sec-17

Lowering Your Baby’s Risk of Peanut Allergy

2018-07-21T21:27:25+00:00July 21st, 2018|Categories: Fertility Blog|Tags: , , |

New research suggests mothers can lower their child’s risk of peanut allergy by eating peanuts during pregnancy and breastfeeding. This is big news since peanut allergy is increasingly common in the US, it effects 1-2% of the population here. And if it seems like more people are suffering from peanut allergy, it’s true. The prevalence of peanut allergy has tripled from .4% in 1994 to 1.4% in 2010 and 2.5% in 2017. Approximately 20% outgrow their allergies after adolescence.

The increasing number of kids with peanut allergies is forcing changes in school cafeteria offerings, airline meals and the labels on baked goods. Tree nut allergy often accompanies peanut allergy and in fact 25-40% are also allergic to walnuts, pecans and almonds. Exposure to allergens cause symptoms to occur within minutes and can cause reactions from mild to life threatening. Symptoms of an allergic reaction are:

• Itchy skin or hives, which can appear as small spots or large welts
• An itching or tingling sensation in or around the mouth or throat
• Nausea
• A runny or congested nose
• Anaphylaxis (less common), a potentially life-threatening reaction that impairs breathing and can send the body into shock

Researchers have been battling the increasing number of peanut allergies for decades. In 2000, pregnant and nursing moms were advised to avoid peanuts, especially if they had a family history of allergies. Parents were also advised to wait until age 3 to give peanuts, when digestion was more mature. This advice was abandoned in 2008 when the rates of new allergy diagnosis continued to rise.

The current recommendation is a complete reversal. In a 2014 study published in the Journal of the American Medical Association (JAMA) of 8,205 children, 140 of whom had allergies to nuts, researchers found that children whose mothers ate the most peanuts or tree nuts, or both, during pregnancy had the lowest risk of developing a nut allergy. The risk was most reduced among the children of mothers who ate nuts five or more times a month.

The researchers, led by Dr. A. Lindsay Frazier of Dana-Farber/Children’s Hospital Cancer Center in Boston, wrote: “Our study supports the hypothesis that early allergen exposure increases the likelihood of tolerance and thereby lowers the risk of childhood food allergy.” They added that their data “support the recent decisions to rescind recommendations that all mothers avoid peanuts/tree nuts during pregnancy and breast-feeding.”

Recommendations from the American College of Asthma, Allergy and Immunology (ACAAI) are in line with the data. In 2017 the group updated their guidelines; recommending early peanut introduction (EPI) beginning around 4 to 6 months of age in infants with severe eczema and/or egg allergy and around 6 months for all other infants. Other studies from around the world show similar results with eggs and cow milk. Early introduction (4-6 months) of these foods reduced the risk of developing an allergy to that food. If you have concerns about introducing peanuts to your baby, follow this link to watch a video from ACAAI for helpful information https://www.youtube.com/watch?v=9pVNFWi0XvU

All the researchers agree more data is required to determine the impact of a mother’s diet during pregnancy and breastfeeding on food allergies. It’s still unclear why some babies develop food allergies and others don’t – if you have concerns about introducing peanuts to your baby, see your pediatrician or allergist for guidance.

This article was writing using these sources-

https://www.mayoclinic.org/diseases-conditions/peanut-allergy/symptoms-causes/syc-20376175
https://ncats.nih.gov/pubs/features/five-ctsas-enable
https://jamanetwork.com/journals/jamapediatrics/fullarticle/1793699
https://acaai.org/allergies/types/food-allergies/types-food-allergy/peanut-allergy

Health Risks of Motherhood Are Higher for African Americans

2018-04-22T04:23:04+00:00April 22nd, 2018|Categories: Fertility Blog|Tags: , , , , , |

As healthcare providers we strive to provide the same care to all of our patients and see good health outcomes across the lifespan, income level and educational status. Mostly, we have been successful – more mothers are insured, home visiting programs have shown promising results and more infants getting their vaccines on time. But as many health disparities are shrinking, one is growing. African American mothers in the U.S. die at three to four times the rate of white mothers, one of the widest of all racial disparities in women’s health. Compared to a white woman, an African American woman is 22 percent more likely to die from heart disease, 71 percent more likely to die from cervical cancer, but 243 percent more likely to die from pregnancy- or childbirth-related causes.

In a national study of five medical complications that are common causes of maternal death and injury, African American mothers were two to three times more likely to die than white women who had the same condition. African American mothers are 49 percent more likely than whites to deliver prematurely (and, closely related, their infants are twice as likely as white babies to die before their first birthday). And the number of complications is rising.
The high maternal mortality rate of African-Americans is the main reason the U.S. maternal mortality rate is so much higher than that of other developed countries. African American pregnant and new mothers in the U.S. die at about the same rate as women in countries such as Mexico and Uzbekistan, according to the World Health Organization.

Experts do not know why African American mothers and babies are dying more than others. In the past, the researchers have assumed poverty, lack of education or low access to quality health care as some of the culprits. But educated African American mothers also have poor outcomes too. One study done in NYC showed college educated African American mothers had worse outcomes than white mothers that had never graduated from high school. According to the CDC affluent and educated black women are more likely to lose their newborn than uneducated white women who’ve had little or no prenatal care. African American women suffer the highest infant and maternal-mortality rates of any race, according to the CDC.

As public health experts try to pinpoint the reason for the disturbing difference in health outcomes, some researchers are taking a new look at racism and the stress it causes across the lifespan. Arline Geronimus, a professor at the University of Michigan – School of Public Health, coined the term “weathering” for stress-induced wear and tear on the body. Weathering “causes a lot of different health vulnerabilities and increases susceptibility to infection,” she said, “but also early onset of chronic diseases, in particular, hypertension and diabetes” — conditions that disproportionately affect African American mothers. Her research even suggests weathering accelerates aging at the molecular level; in a 2010 study Geronimus and colleagues conducted, the telomeres (chromosomal markers of aging) of African American women in their 40s and 50s appeared 7 1/2 years older on average than those of whites.

Weathering may play a part in pregnancy complications too. Pregnancy is the most physiologically complex and emotionally vulnerable time in a woman’s life. As we get older, our risk for complications goes up. The data shows the rate of complications increases for white women in their 40s and for African American women in their 30s. This means that many high risk pregnancies are not monitored as closely as they should be, and more pregnancy complications go undiagnosed in African American mothers.

The risks to mother’s health do not disappear with delivery, according to the most recent CDC data, more than half of maternal deaths occur in the postpartum period, and one-third happen seven or more days after delivery. For mothers with hypertensive disorders, diabetes and peripartum cardiomyopathy the postpartum period should be closely monitored. African American mothers have 25% higher rates of C-section than white mothers and are more than twice as likely to be readmitted to the hospital in the month following the surgery. They are also twice as likely as white women to have postpartum depression, which contributes to poor outcomes, but they are much less likely to receive mental health treatment for the condition. For all of these reasons, new African American mothers need careful monitoring as they recover from childbirth, establish breastfeeding and adjust to motherhood.

Poverty, access to care, culture, communication and decision-making all contribute to health outcomes for mothers and their infants. As researchers continue to discover more about the differences in health outcomes for mothers from all backgrounds, watch for more recommendations to best help our patients.

These are the resources used to write this article. Paste them into your browser to follow the links.

https://www.npr.org/2017/12/07/568948782/black-mothers-keep-dying-after-giving-birth-shalon-irvings-story-explains-why

https://www.ncbi.nlm.nih.gov/pubmed/19788975

https://www1.nyc.gov/assets/doh/downloads/pdf/data/maternal-morbidity-report-08-12.pdf

Breastfeeding as Birth Control

2018-02-21T20:28:40+00:00February 21st, 2018|Categories: Fertility Blog|Tags: , , , , , |

Throughout history, women have used breastfeeding as a natural contraceptive. Researchers have found evidence of Egyptian, Native Alaskan and early European populations recognizing the connection between breastfeeding and family planning. This method of birth control is known as the Lactational Amenorrhea Method or LAM.

The LAM method works because when you are breastfeeding, prolactin production is in high gear. The same hormone that tells our body to make milk, also keeps ovaries from releasing eggs. Without eggs available for fertilization, no pregnancy can occur. Studies show that LAM is 99% effective for short-term contraception as long as guidelines are followed.

The guidelines for the LAM method are simple to follow-

1. Watch for return of menses – For exclusively breastfeeding moms, you can expect to have a 6-12 month break from your monthly “lady’s days.” When your period returns, ovulation often comes too.

2. Exclusively breastfeed – Breastmilk provides all the food and fluid your baby needs to grow. There is no need to supplement with any additional foods until after 6 months or when your baby is ready to start eating complementary foods. Some babies aren’t ready until 7-8 months, watch your baby for signs they are interested in trying new foods.

3. Your baby is under 6 month of age – sleeping through the night 6+ hours and the introduction of complimentary foods usually happen around the 6 month milestone. Ovulation suppression is governed by how much milk you are making so the less milk your baby requires the lower prolactin level and ovulation restarts.

When all three of these conditions exist, you have has less than a two percent chance of becoming pregnant. Since no birth control method is 100% effective, LAM is as effective as condoms or oral contraceptives.

Scientific studies conducted around the world by the Institute for Reproductive Health and other organizations have proven that when guidelines are followed, LAM is an effective, safe, convenient short-term way for breastfeeding women to plan their pregnancies.

Supporting Breastfeeding in Practice

2017-05-12T01:58:10+00:00May 12th, 2017|Categories: Fertility Blog|Tags: , , , , , |

The health benefits of breastfeeding your baby are widely known. The World Health Organization and American Academy of Pediatrics recommend exclusive breastfeeding for the first 6 months of life. The immunity boost provided by mother’s milk leads to lower health care costs, fewer parental absences and less antibiotic use.
Given these facts, it’s tough to believe the backlash against public breastfeeding that we see on a seemingly daily basis. As an active member of the community of breastfeeding advocates, I am surprised by the negative reactions many mothers receive when they feed their baby in a restaurant or retail store. Every week there are new reports of mothers being asked to leave public places, cover up or threatened with indecent exposure charges for feeding her baby. As a nurse and mother of 3, I am immune from the shock of seeing any part of the human body unclothed. Although I can sympathize with the people that do not share my profession, I think those who find breastfeeding offensive can simply look away.

Although science supports breastfeeding, we don’t need to look far to find a social stigma against it. As breastfeeding advocates, it is important that we acknowledge this stigma exists, and then empower mothers in their choice to breastfeed.

There are many ways we can support mothers and mothers-to-be in her breastfeeding journey. Here are some ideas for showing your support for a breastfeeding mother.

• Your words are powerful; if you have a friend or family member that is pregnant, assure her that she can be successful.

• Many mothers don’t have exposure to a breastfeeding role model. If you have breastfed, tell other moms about your experience. The good and bad! It’s important to give a realistic view of breastfeeding. If you only share the great parts your listener is going to perceive any struggles as abnormal.

• Research shows mothers that attend a breastfeeding class during their pregnancy are more likely to start breastfeeding and breastfeed longer. Encourage pregnant women in your life to find out about the options for breastfeeding education in their area.

• Be a good listener. Breastfeeding can be tough in the beginning and she may need reassurance that the struggles will pass and breastfeeding gets easier.

• If you see a mother breastfeeding in public, let her know you support her with a smile or kind word. If I see you nursing in public, I will tell you “Nice job mom!”

• Dads are a critical part of the breastfeeding support system. Encourage him to attend a breastfeeding class, learn why breastfeeding is important and ways he can help mom be successful.

• If you can, encourage your husband or significant other to share his/her experience as your supporter. Dads need positive role models too!

• Keep focus on the positive aspects of breastfeeding – you can travel light without formula, bottles or nipples.

We know the topic of breastfeeding can be controversial due to the sexualization of breasts in American culture.

If we are able to focus on the benefits of breastfeeding and the love we all have for our children, the actions we take to empower mothers in their choice to breastfeed become more essential.

Stress Free Holidays…the breastfeeding part anyway

2014-11-06T13:49:49+00:00November 6th, 2014|Categories: Fertility Blog|Tags: , , , , , |

By Karen Williamson, CLEC, Special Milkies Contributor

The memory still makes me cringe, even though the day was nine years ago. My newborn daughter had nursed very little before we headed out of the house that day for a special visit with my grandma. We were learning the rhythms of breastfeeding and having trouble getting the latch right, so I grabbed a bottle of pumped breastmilk to take along. The thought of having any difficulty breastfeeding in front of my grandma and her new husband was just too much for this brand-new mama.
When the inevitable time arrived and my baby declared her hunger, I pulled out the bottle and jumbled the words, “I brought some of my…umm…extra pumped breastmilk for her.” Meanwhile, my breasts ached with fullness.
Fast-forward to baby number two, at a big family get-together in honor of the same grandmother’s 90-something birthday. My one-year-old reached up for me with an “I want to nurse” pleading in her eyes. Surrounded by relatives, I plunked down in an armchair, struck up a conversation with my cousin’s wife, and happily nursed my little girl. My daughter ended her breastfeeding session with a broad, milky smile, as if to say, “You’ve come a long way, Mom!”
If you’re nervous about breastfeeding in front of relatives and friends during the holidays, try the following confidence-boosters.

Mirror, mirror on the wall…

Practice nursing at home in a chair facing a mirror. Seeing firsthand how little skin is exposed in the cradle nursing position–with baby covering your breast and tummy–may surprise you! Whether you opt to nurse with or without a nursing apron or special nursing clothing, a mirror will reveal what others see. With a little practice, you can nurse with boldness at that holiday party.
Build your breastfeeding support team. Join a local hospital-based or community-based breastfeeding support group. You’ll see veteran moms from all walks of life nursing their little ones. Nursing alongside them will raise your confidence.
Remember everyone deserves to eat! Tune out the rest of the world by focusing on your baby’s needs. Witnessing the sweet bond that breastfeeding has created between you and your little one may convince a young female relative at your family get-together to breastfeed later in life.
Shop with a sling on. As baby grows older and nursing becomes more automatic, a sling frees your hands to snatch up those holiday bargains at the mall or grocery store. As an added benefit for moms desiring extra privacy: slings with sashes can be swept over one shoulder on the side that baby is nursing.

“You’re still breastfeeding?”
Receiving breastfeeding criticism from family or friends can really put a damper on your holiday spirit. My friend Stacy once told me about a family member who inquired how long she planned to nurse. Says Stacy, “When I said one year, she responded that dogs don’t even nurse that long.” Then Stacy’s witty reply was, “My baby girl is not a dog. My baby could have a lifespan of a hundred years, so my commitment of nursing her for a full year is actually not very long at all.”
Remember: criticism of nursing is often a reflection of the critiquer’s personal guilt surrounding not breastfeeding their own child. Criticism may also indicate that the individual is inadequately informed on the many health risks of not breastfeeding. Avoid a heated debate with a simple reply such as, “I appreciate your concern…” followed by a change of subject, or a good-humored joke about your baby being weaned by college.

Take-out pizza, for nursing harmony!
By now you should be feeling more prepared to nurse in public this holiday season. But keeping up with breastfeeding sessions so that your milk supply doesn’t dwindle in the midst of all the hustle-and-bustle may still feel challenging. To devote more attention to nursing, lower the bar a bit on your holiday expectations. And try shopping online for most gifts.
A dear mom pal of mine, Melissa, insists that one of the most enjoyable and relaxing holidays she experienced while nursing a little one was when her husband encouraged her to buy pre-made pizzas instead of preparing a fancy homemade spread for their family Christmas dinner. “My older kids are rather picky eaters anyhow, but they love pizza!” she shares. She was able to nurse at leisure while keeping everybody happy.

Holiday breastfeeding well-wishes
Here’s wishing you and your nursling a magical holiday filled with confident and peaceful nursing moments, plenty of breastmilk, and nary a single breastfeeding naysayer!