Categories
Mindful Parenting Motherhood

On Parenting In A World Of Distraction

Recently, my 2-year-old son has started this new habit. He walks up to where I’m sitting, and he pulls on my arm. Specifically, he pulls on the wrist that is attached to the hand that is attached to my smartphone, and he asks me to get up.
If I’m being perfectly honest, it frustrates me. I don’t feel like I’m constantly on my phone, and typically I am trying to accomplish something for work when he interrupts. It wasn’t until more recently that I even considered that my distraction might be the problem—I kind of assumed he was just being a 2-year-old.

HealthyWay
iStock.com/LSOphoto

I’ve worked from home for four years now. Even though I do have childcare pretty regularly, I also do a lot of multitasking while my kids play or sleep. I’ve worked really hard to try to maintain some kind of balance, to draw lines between work and home, but that hasn’t always gone well.
It wasn’t until my son began this habit of pulling on my arm that I realized this might be one of those seasons that isn’t as in balance as it should be. It wasn’t until I noticed how much frustration I felt being pulled away from my email or texts that I became open to the idea that I might not be doing the best job keeping the lines between motherhood and work in check, and that I might be letting tech become an unhealthy distraction.

Redefining Balance in a Digital World

When I first started to research tech distraction and parenting, I was nervous. My expectation was that I was going to find a mountain of evidence that I needed to draw hard lines between work and home. I expected I was going to walk away from my research believing I only had one choice—to give up stay-at-home parenting altogether and hire full-time care so I wasn’t so distracted by my tech devices around my kids.

HealthyWay
iStock.com/lolostock

This wasn’t what I found to be true. Instead, I found experts are calling not for a complete absence of technology in family life, but a smarter, healthier approach to using and talking about technology. They’re calling for more intentional integration.

The Problem with Tech Distraction

Before I can get serious about changing the way our family approaches tech, I know I need to get clear on what problems tech-distraction creates for the modern family. Knowledge is power, right? In this case, the hope is that information will motivate lasting change in our family.

HealthyWay
iStock.com/Marina_Di

There is a lot of research on screen time and how it impacts children, but the body of research on parental use of screens and how it impacts family is still developing. What I find interesting about the research that does exist is its logical progression.
First, there is research confirming that children are more likely to act out when their parents are distracted by tech. Specifically, a study published in Child Development reported that when parent-child interactions are frequently interrupted by technology, parents are more likely to report that their children have behavioral problems.
HealthyWay
iStock.com/PeopleImages

Another study published in the journal Pediatrics observed families in a fast food restaurant, making note of their smartphone use and how it appeared to affect their interactions with their children. Researchers noted that 40 of the 55 observed parents used their smartphones during their meal. When left to entertain themselves (because of parental engrossment in technology), children were more likely to seek out their parents’ attention.
https://twitter.com/katie_willcox/status/1016892865006297090
“Parents who are distracted by their smartphones are more likely to see kids misbehaving because kids will have to misbehave in order to get their attention,” explains Shane Gregory Owens, PhD, a board-certified psychologist who works with families and young adults. “Parents with kids who learn that the fastest route to attention is misbehavior will end up with kids who misbehave.”
In this same study, we see another consequence of tech-distraction—parents who appeared to be very distracted by their phones were more likely to respond harshly when their children acted out or tried to get their attention.
HealthyWay
iStock.com/killerb10

Most impactful, perhaps, is research on living in a digital world sponsored by AVG Antivirus. In 2015, they surveyed parents and children on family tech use and found that over half the children felt their parents were on a screen too often. Thirty-two percent of these children said the amount of time their parents spend on their phones makes them feel they are not important to their family.

Dealing with Our Tech Fascination

It is worth noting that many parents, like myself, are not unaware of the problem of technology in our lives. In the study mentioned above, 52 percent of parents admitted they were on their phones too often.
“My biggest concern … is that they’re really modeling behaviors that they’re not actually interested in their children picking up,” says Colleen Carroll, doctor of education and self-proclaimed screen freedom warrior. “It is not helping them as a parent to have credibility, and they lose the respect of their children.”

HealthyWay
iStock.com/SolStock

In my own life, and what I suspect is the case in many families, using tech less is easier said than done. I am drawn to social media when I am bored, lonely, or simply exhausted. Being on a screen provides me with a positive experience that keeps me returning again and again, even when I’ve committed to using tech less.
For this reason, dealing with our tech fascination just might be the first step to a more balanced approach to technology and family life. If you find yourself compulsively reaching for your phone, Carroll offers some practical steps you can take to make phones less interesting.
“Almost all smartphones have the option to make the screens black and white instead of color,” she says. “Color saturation is one of the main addictive qualities of devices today.”
HealthyWay
iStock.com/amenic181

Turning your phone to grayscale could be your first step toward becoming less fascinated with your phone. For those interested in making this switch, it’s an option usually found in the accessibility section of the general settings menu.
Next, permanently turn off all notifications on the apps on your phone. That way, you have to go out of your way to check emails, social media, or gaming apps.
HealthyWay
iStock.com/milindri

Lastly, she suggests protecting periods of time devoted to other things, like work or time with family, by turning your phone on airplane mode. It’s a simple way we can all disconnect for a bit for the good of our mental health and our relationships.

Changing the Family Culture

The goal of a healthy relationship with technology is not to give it up completely. Disconnecting entirely isn’t just impractical, it’s impossible for most.
“The idea that any of us is going to be able to be very strict about work versus family time, at least right now, it doesn’t seem possible,” says Owens.


Instead, Owens encourages parents to be very intentional about how they use tech at home. Parents who hope to see a positive change in the family dynamic surrounding technology need to step back and take a look at the family culture as a whole, according to Carroll. This can be accomplished by clearly defining your family values and then making concrete changes to center schedules and routines around them.

HealthyWay
iStock.com/yacobchuk

“Families have success by creating designated work times where everybody can be on devices at some point,” she says. “For some families, it is between 7 and 9 p.m.; for other families, it’s more like 4 in the afternoon and 6:30.”
This time can be used in a way that works best for the family. This is the time when parents can catch up on work, kids can complete computer-based homework, and families can enjoy entertainment technology together.
[pullquote align=”center”]”The most important tool that any parent has is modeling the behavior they want to see in their kids.”
—Shane Owens, PhD, psychologist[/pullquote]
“Then there is an agreed upon shut down time so that everybody is also following that, and then they can do the other helpful activities that are really necessary on a nightly basis,” Carroll says, suggesting reading, bedtime routines, or even watching a show together as a family.
Building this schedule or routine is the perfect time for a formal discussion as a family about what the family values most and how they plan to make that a priority over screen time.
HealthyWay
iStock.com/shapecharge

“The family should get together and say, ‘Here’s why we don’t spend five or six hours a night on screens or playing video games,’” she says, providing outdoor time, reading, or socializing together as activities that could be scheduled in place of mindless screen time.
These two suggestions are part of a larger point that both Owens and Carroll stress as important. Parents need to explicitly talk about technology with their children. Children will make assumptions about their family values based on what they see and hear from parents, and if we don’t talk about why we’re not devoting our lives to screens, kids will likely get caught up in being connected.
HealthyWay
iStock.com/Mladen Zivkovic

“The most important tool that any parent has is modeling the behavior they want to see in their kids,” says Owens. “So parents want kids to pay attention to them when they’re talking, so if your kids talks to you and you are on your phone, you put down your phone and you look at your child and pay attention to them until they’re done talking.”
Additionally, he recommends wrapping up this interaction by clearly spelling out that you are going to go back to work, but that you plan to spend time together once your allotted work time is over.
HealthyWay
iStock.com/Geber86

What does this mean for me and my family dynamic? That’s a question I’m still exploring, beginning with talking with my spouse about how we want to start scheduling in screen-free family time on a daily basis. As someone who has grown into adulthood on tech, these changes don’t feel easy, but I believe they are worth the improvements to our quality of life and the relationships we have with one another.

Categories
Healthy Pregnancy Motherhood

What You Need To Know About Pitocin Induction

By the time Emily Theys got to 41 weeks pregnant with her first child, the baby was showing no signs of coming out. Theys was only a couple of centimeters dilated and not fully effaced, and her doctor predicted that her baby was on the bigger side (while Theys has a smaller frame). An induction was ordered. On the morning of the induction, the doctor started the Pitocin drip at 7 a.m.
You may have heard of Pitocin inductions—and horror stories and tales of success alike—but before you agree to a Pitocin induction, it’s important to know what Pitocin is and how it can affect your labor and birth.

What is Pitocin and how does it work?

Pitocin is the synthetic form of oxytocin, the naturally occurring hormone thought to control—at least in part—uterine contractions (in addition to being the “love hormone”!).
Pitocin works by causing the uterine muscles to contract periodically, causing the contractions required for vaginal delivery.
Pitocin is administered through an IV and is increased gradually until the patient is in labor, explains Sara Twogood, MD, an OB-GYN and assistant professor at the Keck School of Medicine of the University of Southern California. The dose is usually increased every 30 to 60 minutes.
The dosage often varies from woman to woman: “Some women will need a very little dose and some will need the maximum dose,” explains Twogood. “We can’t predict that ahead of time. I usually tell women that with their first baby, we anticipate delivery about 24 to 36 hours after the induction starts. For women with their second, third, fourth babies, the induction process is usually a lot faster.”
The fetal heart rate, uterine contractions, and patient are monitored to ensure the baby is tolerating the contractions and the dose is adjusted as needed. (That said: Pitocin won’t work unless your cervix is favorable—meaning you have a relatively high Bishop Score and your cervix is soft and effaced.)

Pitocin and C-Sections: Are they related?

When Theys’ Pitocin induction started, she was immediately hooked up to a monitor. By the middle of the afternoon her water broke. Although she was having contractions—she could see them on the monitor—she couldn’t feel anything, despite not having an epidural.
She’d expected to endure the Pitocin with no additional drugs (“I have a high pain threshold!”), but soon it became unbearable. She kept at it by watching the monitor so she could see when a contraction was coming. “It helped because I could see when it was going to end. But soon they became really unbearable, like sharp lightning pains to my gut and through me. I was doubled over, clenching onto something.”
Over the next few hours, with the Pitocin turned down, Theys never dilated to more than 9 centimeters and, 24 hours after her water broke, she was rushed into an emergency c-section.
[pullquote align=”center”]“I think Pitocin sometimes gets a bad reputation, but looking at it from this perspective can be helpful.”
—Sara Twogood, MD[/pullquote]
Theys is far from the only one who’s been induced with Pitocin only to end up in the operating room. A 2004 study showed that of over 1,600 women who had Pitocin used either to induce labor or to augment spontaneous labor, the former group had a higher-than-average c-section rate.
However, according to Twogood, the main reason Pitocin is associated with an increased risk for c-sections has more to do with the indication for Pitocin than the Pitocin itself, assuming Pitocin is being used safely. In other words, Pitocin is used to augment labor when it is is not progressing as expected.
“Labor not progressing as expected is associated with an increased risk for a cesarean,” she says. “Using Pitocin in this scenario can help decrease the need for a cesarean. I think Pitocin sometimes gets a bad reputation, but looking at it from this perspective can be helpful.”
Rosemary Dardick, mom of 3-year-old Ella, in L.A., was administered Pitocin—and it did lead to a vaginal birth. Dardick was induced on her due date because she had started to show signs of preeclampsia; her induction process started with misoprostol, which barely did anything. The next day her doctors tried to induce labor with a balloon (also known as a Foley bulb)—a procedure she wound up enduring twice.
“Those were awful from start to finish,” she says. “They hurt while they were being inserted and the first one hurt coming out too. The second one worked faster than the first. Ella was sunny side up and it wasn’t clear if she was going to be able to turn herself around.”
[pullquote align=”center”]“The main—and intended—effect of Pitocin is painful uterine contractions.”
—Sara Twogood, MD[/pullquote]
After receiving Pitocin, however, Dardick’s contractions progressed very quickly. “Whereas before I would mainly be able to tell I was having a contraction by looking at the monitor, I definitely felt them after the Pit,” she says. “The epidural was awful and I still have lingering effects from it, but I can’t imagine laboring without it after the Pitocin.”
The dosage was turned up and down for Dardick, too. “They tried to labor me down for an hour or so Monday morning so I’d be able to rest for a bit, but after two days of prodding, Ella was suddenly ready to go immediately,” she says. “In fact, the nurse almost delivered Ella because the doctors couldn’t get to my room fast enough. So while the inducement lasted a long time, I was only in active labor for about 30 minutes. She’d turned herself around and was no longer sunny side up.”

Side Effects of Pitocin

Remember Theys’ horrific contractions? She wasn’t wrong that they were truly unbearable. “The main—and intended—effect of Pitocin is painful uterine contractions,” says Twogood. “It’s thought these contractions are more painful and stronger than spontaneous labor contractions, but this is clearly very difficult to study and know.”
In addition to extremely painful contractions, for some women, Pitocin can cause water retention. Other side effects may be skin flushing, fast heart rate, nausea, or vomiting. But Twogood is quick to point out that most women tolerate Pitocin very well.

Why Doctors Induce With Pitocin

“Inductions are usually recommended when the risks of continuing the pregnancy are higher than the risks of induction and delivery of the baby,” explains Twogood. This means that the baby is premature but continuing the pregnancy is too dangerous.
Some other indications include preeclampsia, chronic hypertension, gestational or pre-gestational diabetes, cholestasis of pregnancy, placental insufficiency, concern about fetal well-being or fetal growth restriction, low amniotic fluid, intrauterine infection, premature and/or prelabor rupture of membranes, twins, or going past your due date.
Many doctors rely on other medications or methods to induce labor before getting to Pitocin. The most common ones? Cervidil, transcervical balloon catheter, misoprostol (or Cytotec), and rupturing the membranes. “Membrane sweeping, nipple stimulation, and castor oil may help, and I use these techniques when we are trying to coax spontaneous labor,” Twogood says, “but they are not as effective as the other techniques so I don’t rely on them solely when induction is medically indicated.”

Risks of Pitocin Induction for Mom

You can’t move around.

Once on Pitocin, you have to stay in bed and be strictly monitored, which means no more wandering around, sitting on a birthing ball, or any of the other laboring techniques you may have learned.

You can’t eat anything.

This is because you risk asphyxiation if you need an emergency c-section—which requires going under anesthesia.

It might not work.

According to the Mayo Clinic, 75 percent of inductions end in a vaginal delivery—which means that 25 percent end in emergency c-sections, like Theys’.

Too strong contractions can tear the uterus.

This is more of a problem for women who are opting for VBACs (vaginal birth after c-section).

Risks of Pitocin Induction for Baby

Some babies don’t react well to the intense contractions that come along with Pitocin, which can lower their her heart rates, sometimes necessitating an emergency c-section.
As for other effects on the baby after birth, Twogood says, “Pitocin does cross the placenta and may have similar effects as in the mother, but that is rare. Newborns to mothers who received Pitocin during labor are not treated or evaluated differently than newborns who were not exposed, and there’s no evidence or link to adverse neonatal outcomes.”

Pitocin Use After Delivery

Sometimes the uterus won’t stop bleeding after birth, so Pitocin is used to stop the bleeding by “squeezing down on the raw blood vessels exposed as the placenta is released.”

Pitocin and Autism: Is there a link?

According to the American College of Obstetrics and Gynecology, there is no causal link between the Pitocin and autism spectrum disorder (ASD). A document endorsed by the Society for Maternal–Fetal Medicine states thatalthough the cause of ASD is unclear, it demonstrates a strong genetic predisposition and multifactorial influences. A wide variety of exposures, including many perinatal factors, have been linked to ASD but the suggested associations in many cases are weak, inconsistent, or both among studies, and cannot be equated with a cause and effect relationship

Categories
More Than Mom Motherhood

29 Things My Mom Taught Me (And 5 Things She Wasn't Right About)

With all due respect to all of your moms, I have to claim the mantle of having the best mom in the world. (Yes, I know a lot of us think that! We are the lucky ones.)
I’m obviously no longer a child, but I tend to listen to my mom and still think she’s right about most things. In fact, I call her to consult on almost all major matters in my life. So I got to thinking: What are my favorite things she taught me?
There are only a few things we really disagree about, so most of her advice here is sound and can be passed on to any child (or adult!).

29 Things My Mom Taught Me

  1. Recycle everything.
  2. Always make homemade desserts. (Store-bought ones are unacceptable.)
  3. You must eat salad after a main course.
  4. Take your kids to see live theater.
  5. Buy books (but wait for the paperback).
  6. Keep in touch with old friends.
  7. Eat dinner together every night—with whom you’re “together” is up to you.
  8. Learn another language.
  9. Write well.
  10. Show up for people.
  11. Be loyal to your friends.
  12. When someone is sick or hurting, call them.
  13. Try again.
  14. Drink tea in the afternoon.
  15. Enjoy good wine.
  16. If you like a shirt, buy it in four colors.
  17. The person who cooks doesn’t clean.
  18. Talk it out—with a friend or a spouse.
  19. Use cloth napkins.
  20. Stand up for things you believe in.
  21. Say “I love you” all the time.
  22. Let your kids be who they are.
  23. Invest in high-quality clothing.
  24. Make time for exercise.
  25. Put wet laundry in the dryer for at least 10 minutes so it doesn’t wrinkle.
  26. Read, read, read.
  27. There’s no shame in watching trashy TV.
  28. Walk whenever and wherever you can.
  29. Take notes.

5 Things My Mom Wasn’t Right About

1. Tea bags need to steep for more than three seconds.

My mom has a thing about dipping her tea in hot water for so little time that there’s no way it tastes like anything other than…hot water. It’s gross. I am a firm believer in steeping tea for a long time for a really dark, deep taste.

2. Not all religion is bad.

Okay, this one is rather heavy and controversial, but my mom is fervently anti-religion. She grew up in a communist home, but in adulthood I’ve taken great comfort in some aspects of Judaism. I’ve had to come to terms with the fact that we will never see eye-to-eye on this—and that that’s okay.

3. T-shirts do need to be thrown away when they have holes in them or are totally faded.

My mom still wears T-shirts from the 1990s. Since she is a writer who works from home, she rarely needs to fully put herself together. This means that when my sister and I recently helped her clean out her closet, we found a lot of shirts with frayed necklines…that she didn’t want to throw out. Not okay.

4. There’s no need to keep newspapers.

My mother has devoutly been holding onto newspapers for as long as I can remember. Every few months she clears out the massive pile from the closet. Why not just recycle them the following day?

5. It’s not good to hold grudges.

My mom is really good at holding grudges, sometimes (?) for good reason, which has made me think it’s okay to hold grudges. Not so. What’s the point? You are only making yourself miserable. Let it go.

Categories
Healthy Pregnancy Motherhood

Busting Prenatal Ultrasound Myths: What to Know Before You Go

When you’re expecting, you spend a lot of time worrying—particularly during your first pregnancy.
“I read everything I could get my hands on,” says Mary, a 27-year-old St. Louis resident who had her first baby last April. “I was really obsessed with things like nutrition, but I never second-guessed ultrasounds. Then, on [social media], one of my friends posted an article about how fetuses can hear during ultrasound examinations, and that got me thinking.”

HealthyWay
iStock.com/YsaL

In fact, dozens of publications carried the story, in which ultrasound equipment was said to be “as loud as a subway train coming into a station” to the fetus.
That sounds alarming, so we decided to look into the science. Spoiler alert: Ultrasounds are completely safe when performed by properly trained professionals. However, some of the enduring myths surrounding ultrasounds deserve some attention.
HealthyWay
iStock.com/PeopleImages

[Editorial note: Ultrasound is the name for the procedure itself, while sonogram is the name for the image produced; as we use both terms throughout this article somewhat interchangeably, we felt some clarification would be helpful for anyone unaware of the distinction (we certainly weren’t aware of it when we started researching).]

“Fetal ultrasounds can cause hearing problems in babies.”

On the surface, this myth sounds sensible; ultrasounds use acoustic waves of energy—in other words, sound—to create images. We also know babies can hear sound (and even learn words) in the womb. Wouldn’t a tremendous amount of sound pose some sort of danger?

HealthyWay
iStock.com/skynesher

While ultrasounds might be audible for newborns, there’s absolutely no evidence that they’re dangerously loud. In fact, ultrasound equipment uses high frequencies not audible to adult or infant ears. They can potentially stimulate vibrations in the uterus that could be problematic, according to the Mayo Clinic’s Mostafa Fatemi, but not dangerous to the fetus’s developing ears, provided the equipment is used properly by trained medical professionals.
Fatemi, by the way, is the source of the “louder than a subway train” comment, but that was taken out of context by some publications; Fatemi was warning that excessive levels of high-frequency sound might cause a fetus to move in the womb, potentially leading to complications. He wasn’t concerned with potential hearing loss, and subsequent studies have shown that ultrasounds don’t pose that type of threat.
HealthyWay
iStock.com/NataliaDeriabina

In 2013, a group of researchers attempted to establish a link between prenatal ultrasounds and hearing loss, noting that the implications for public health would be “enormous” if such a link was found. The study looked at postnatal hearing tests, comparing babies who’d had ultrasounds to babies who hadn’t undergone the procedure.
“Our results show that there is no correlation between a higher level of prenatal ultrasound exposure and hearing loss,” the authors concluded. “Indeed, infants who had more prenatal ultrasounds in the third trimester were more likely to pass their screening hearing exams.”
HealthyWay
iStock.com/Steve Debenport

That would seem to indicate that ultrasounds actually help infants’ hearing, but the researchers warned against making that conclusion, noting that correlation doesn’t imply causation. In any case, the takeaway is clear: Ultrasound equipment, when used properly, is perfectly safe for your baby’s ears.

“Sonograms are loaded with dangerous radiation.”

Many mothers-to-be wonder why they should expose themselves to any medical imaging equipment. Don’t those things expose your body (and, therefore, your baby’s body) to dangerous radiation?
In a word: Nope.

HealthyWay
iStock.com/sergeyryzhov

“There is no radiation involved,” explains Resham Mendi, MD, a radiologist with Bright Light Medical Imaging.
Certain other medical imaging technologies (specifically, CT scans) use ionizing radiation, which could conceivably damage DNA, causing diseases like cancer. Medical professionals go to great lengths to minimize those risks—but because ultrasound equipment uses sound, not x-rays, it doesn’t pose the same type of danger. The sound waves simply aren’t capable of damaging DNA.
By the way, ultrasounds generate images pretty much instantaneously, which is why they’re more effective than CT scans or MRIs for prenatal care.
HealthyWay
iStock.com/thomasandreas

“Ultrasound allows us to see things inside the body as they move,” Mendi says. “This is why we can evaluate the motion of the heart, of a fetus, or of a needle that a doctor may be inserting for a biopsy. Normally, it’s a completely safe and pain-free process.”

“The FDA recommends against fetal ultrasounds.”

Some sites note that the FDA advises against unnecessary prenatal ultrasounds. This is actually partially true, but it requires some context. The FDA did release a consumer update advising against “keepsake” sonograms and, in the accompanying online materials, warned about the dangers of those ultrasounds.

HealthyWay
iStock.com/nd3000

“Although there is a lack of evidence of any harm due to ultrasound imaging and heartbeat monitors, prudent use of these devices by trained health care providers is important,” Shahram Vaezy, PhD, an FDA biomedical engineer, said in a statement. “Ultrasound can heat tissues slightly, and in some cases, it can also produce very small bubbles (cavitation) in some tissues.”
However, the FDA’s report is specifically geared toward vanity sonograms—which, by definition, aren’t medically necessary.
[pullquote align=”center”]”Although ultrasound is safe during pregnancy, physicians are discouraged from performing vanity ultrasounds if they are not needed, as it exposes the fetus to additional ultrasound energy with no medical benefit.”
—Janelle Cooper, MD, obstetrician[/pullquote]
“I have some patients who have gone on their own to commercial ultrasound centers offering so-called ‘vanity’ ultrasounds or for 3D ultrasounds to get pictures of their baby’s face,” Janelle Cooper, MD, Fellow of the American Congress of Obstetricians and Gynecologists, and obstetrician at Mercy Medical Center in Baltimore, tells HealthyWay.
Why would someone want a 3D ultrasound?
“Not all patients need a 3D ultrasound, so it is not typical to have it done for medical purposes, but many patients are anxious to see what their baby looks like, and with 3D technology—it does provide a rough image of the baby’s face,” she says.
HealthyWay
iStock.com/fotostorm

That does sound pretty cool. Alas, if a 3D ultrasound is unnecessary, it’s not worth the (incredibly small) risk.
“Although ultrasound is safe during pregnancy, physicians are discouraged from performing vanity ultrasounds if they are not needed, as it exposes the fetus to additional ultrasound energy with no medical benefit,” Cooper says. “In addition, patients may get these ‘vanity’ ultrasounds and be falsely reassured that their baby is healthy, and many of these ultrasounds are not done by qualified sonographers who have experience with obstetrical ultrasounds. The ACOG [American College of Obstetrics and Gynecology] has issued guidelines for use of ultrasound in pregnancy, which state that exposing the fetus to ultrasound energy without medical benefit is not justified.”
HealthyWay
iStock.com/thomasandreas

In other words, while you might really, really want to see your baby’s adorable face a few weeks early, resist the urge to book an extra appointment at the sonographer’s office. Hey, relax; you’ll get to take much better pictures once your baby is actually, you know, born.

It’s helpful to understand how sonograms are used (and why they’re important).

We ask Cooper whether a physician might recommend against ultrasounds for any reason.

HealthyWay
iStock.com/7postman

“I do not believe there is any evidence to show that sonograms are not safe during pregnancy,” she says. “As an obstetrician, there is no reason why I wouldn’t recommend ultrasound during pregnancy, as it has been proven to be safe, and generally, no harm can come to the baby with multiple ultrasounds during pregnancy.”
All medical procedures carry some amount of risk, and ultrasounds are no different. According to the ACOG, no research indicates that ultrasounds present any danger to a developing fetus, but that might change at some point in the future, so physicians try to avoid using the technology unnecessarily. At this point, the benefits of ultrasound technology seem to greatly outweigh the known risks.
HealthyWay
iStock.com/September15

“Ultrasound is a tool that we use to help determine how the pregnancy is progressing, to evaluate the baby’s growth, anatomy, and wellbeing overall, and to monitor the placenta for any changes that may prove dangerous to the pregnancy,” Cooper says.
We had to ask: Why are sonograms really necessary, and how many should a mother expect to have during pregnancy?
“Generally, during pregnancy, I recommend an ultrasound in the first trimester to help determine due date in comparison to the last menstrual period,” Cooper says. “I recommend this ultrasound starting at around six weeks. There are times when I may recommend an earlier ultrasound if there is any suspicion of possible miscarriage or to confirm that it is not an ectopic pregnancy, and even this [is safe] early on when the ultrasound is done transvaginally.”
HealthyWay
iStock.com/artursfoto

“In a normal pregnancy, the next ultrasound is usually done at 18 to 20 weeks for a full anatomy evaluation, as well as gender determination. I recommend patients get ultrasounds done at least three times minimum during pregnancy, once per trimester, as overall, ultrasounds will help determine fetal growth, anatomy, placental abnormalities, gender, presence of [twins or multiples], the location of pregnancy, and the size [and] weight of the baby.”
Ultrasounds help doctors—and mothers—prepare for a healthy delivery. While the technology can seem somewhat overwhelming, and the procedure itself is a bit uncomfortable (okay, really uncomfortable), that’s no reason to ditch the sonogram entirely. Just ask someone who’s been there.
HealthyWay
iStock.com/Ivanko_Brnjakovic

“I totally get why people are anxious about sonograms,” Mary says. “But they do give you a sense of relief, and after doing the research—there’s no real reason to worry.”

Categories
Mindful Parenting Motherhood

Current Events For Kids: How To Tell Your Kids About The News

No matter your politics, we can all agree that the last few years have been overwhelming. Thanks to social media and 24-hour news cycles, there is a lot of news, and most of it is quite scary and destabilizing: The 2016 election is still in our rearview mirror, and even preschoolers know the names “Trump” and “Hillary.” Small kids have been separated from their parents and detained. U.S. Immigration and Customs Enforcement is arresting people in their homes and workplaces.
Four young girls hold up feminist signs at a women's rights rally as they learn about current events.
And a lot of our kids are asking about it. That leads us to wonder, how much should our kids really know? How much should we share with them, and what should we hide? How do we keep them feeling safe when the world doesn’t seem very safe at all?

Should I teach my kids about current events?

With very little kids, it’s best to steer clear of explaining the news completely. “When there’s an election that’s preoccupying their parents, we might do a mock election at the preschool,” explains Jane Rosen, PsyD, child clinical psychologist and director of education at the IKAR ECC preschool in Los Angeles. “Current events have to be broad or catastrophic to pay attention to them [think: 9/11], and physical distance matters.”
If a catastrophic or nearby event is impacting your child’s life, it’s important not to be too vague—or too specific or graphic. Because they hear things from friends or other adults, your first question should always be: What do you know, and what have you heard?
Even if the event you’re discussing happened nearby, if the kid is younger than 5, you want to, first and foremost, reassure them: I will do everything I can to protect you.

Current Events That Aren’t for Kids

“Anything can be harmful or not, depending on how it’s messaged,” explains Rosen. “Young children have no capacity to make sense of what they’re seeing or hearing. They see that people are frightened, and they resonate with the feelings, but can’t process the event itself.”
Remember, too: Kids as old as elementary-school age may not understand that an image being repeatedly shown on a loop on TV or online is not happening over and over again. (Think, again, of September 11.)
Children may think it’s continuously happening, and this is terrifying. “Much repetition of graphic imagery is upsetting and has a nightmarish quality,” says Rosen. “Find ways that you can do something to help them process an event that makes no sense.”

How to Talk About Current Events With Your Kids (or Not)

  • Keep graphics to a minimum. Discussing a recent event with your child is much different than them catching glances of blurry, confusing footage for which they have no context.
  • Turn off the TV and put away your phones. There’s no need for them to watch the pundits constantly talking on cable news, and they certainly don’t need to be reading the opinions of the masses on social media.
  • Talk to your child about what we can do to be helpful and stay safe. You can say: Sometimes really scary or bad things will happen, and we will keep you safe.
  • Reassure them that their world will stay safe. If it’s not an authentic statement—if, for instance, you really fear ICE coming to pick you or your child up—explain what steps you are taking to try to keep everyone safe.
  • Give them multiple venues to express their feelings. Drawing and playing are good ways to get things out.

How to Get Your Kids Involved in Current Events

Talking about current events is one thing, but what about kids who want to get involved? That’s not a bad thing, but depending on their ages, you’ll want to be vague.
For instance, some kids at an L.A. preschool recently painted pictures for migrant children who were separated from their parents and detained by the American government. Did the teachers tell the kids all about the kids’ circumstances? No way. If you’d like to do something similar, the message can be: We’d love for you to draw pictures to cheer children up who are sad. The teachers didn’t say they were away from their parents or out of their homes.
It’s nice—and important!—to involve children in what’s happening in the world: collecting diapers, delivering food to those in need. “These instill ideas about healing the world, and that they have a place in it,” says Rosen. But you want to keep it simple at this age.
With slightly older children, you want to help them look for the helpers. There will always be helpers. (We miss you, Mr. Rogers.) Ask them, What can we do to help? “Children that age are action-oriented,” Rosen says. “Can you gather blankets? Cash in some allowance to send money?”
Kids want to be given something to do. Being proactive keeps us from sinking into despair.

Little Activists: Taking Current Events a Step Further

So, should you start molding little demonstration-attending activists in your household? By all means!
But you need to think about the how, when, and why. Who is this protest for? And why do you want to bring your kid? Is it a childcare issue, or is this vital to your family culture?

A mother teaches her kid about current events by bringing him to a protest in Philadelphia.
iStock.com/basslabbers

“I don’t think very young children belong some places,” says Rosen. “You can bring a baby along on a march as long as it’s safe. But the idea that you’ll inculcate your 2-year-old can be inappropriate, and [protests] can be violent. Something peaceful can turn in a moment.” Rosen—who protested the Vietnam War along with her parents—suggests waiting until the kids are closer to 9 or 10.
It’s also important to think about what is being communicated. A 5-year-old who is about to start kindergarten might not feel safe at an anti-gun rally, but a 10-year-old who worries about this issue might be feel empowered by it. You know your kid best, but be mindful of developmental differences in ages, too.
Rosen adds that anything about family separation or where children are being abused is better left unmentioned to a small child. “It’s amazing what sticks, and what comes out in different expressions of anxiety.”
[related article_ids=7068,1003349]

Categories
Mindful Parenting Motherhood

How To Choose A Prenatal Vitamin That's Actually Worth It

Whether you recently learned you’re pregnant or you’re thinking about trying to conceive, you’ve got a long list of stuff to do. One thing that needs to be pushed to the tippy top of that list? Buy a bottle of prenatal vitamins and start taking them, ASAP.
We can already hear the questions formulating: If I’m not even pregnant yet, do I really need a prenatal vitamin? and If I’m already taking a multivitamin, isn’t that enough to cover me?
The quick answers are yes and no, but we talked to the experts to find out why you need to take prenatal vitamins when you aren’t even pregnant yet and which are the best prenatal vitamins for you.

What are prenatal vitamins?

The word “prenatal” in the name is a pretty big clue here: These are special vitamins meant to be taken before giving birth, and that sets them apart from your average multivitamin.
“The key nutrients in prenatal vitamins are iron and folate,” explains Bradley Price, an OB-GYN from Austin, Texas. “Iron is a key building block in the machinery for getting oxygen to every part of the body, as well as through the placenta to baby. Very few women have adequate iron stores in their bone marrow, so iron supplementation during pregnancy is crucial.”
[pullquote align=”center”]While a general multivitamin supplement can be helpful for the average population, Price says they’re no replacement for prenatal vitamins.[/pullquote]
That extra iron in prenatal vitamins helps prevent anemia for moms-to-be during pregnancy, and it also helps women avoid the risk of blood transfusion if blood loss is higher than average during delivery.
Prenatal vitamins are also packed with folate or folic acid, a B vitamin that Price calls “one of the most important nutrients women can take to protect the health of the baby.” Among the benefits of folate touted by doctors is a lower risk of baby developing neural tube defects such as spina bifida and anencephaly and a lower risk of preterm birth, which carries with it a variety of risks to a baby.
Dietary guidelines from the American College of Obstetrics and Gynecologists recommend that pregnant women get at least 600 micrograms of folic acid daily from all sources for that reason, and sources can include prenatal vitamins.

The Difference Between Prenatal Vitamins and Regular Vitamins

But you’ve got a multivitamin you’ve been taking for years, so you’re all set, right? Well, unless it’s specifically labeled “prenatal,” probably not.
While a general multivitamin supplement can be helpful for the average population, Price says they’re no replacement for prenatal vitamins as they’re designed specifically for the nutritional needs of those who are pregnant—and their babies.
Even grabbing your Granny’s vitamins thinking it’s better than nothing could put you and baby in a bad spot, he explains, because “supplements marketed for the elderly contain very little iron because this age group requires minimal iron and are actually at higher risk for getting too much iron.”

When to Start Taking Prenatal Vitamins

In part because of the name, there’s a common misconception out there that prenatal vitamins are only supposed to be taken by pregnant women, says Kara Manglani, a certified nurse midwife and founder of The Fertile Times.
“Ideally, you should start taking prenatal vitamins three months before trying to become pregnant,” Manglani says. “In fact, there is no downside to taking prenatal vitamins, so the earlier the better.”
That’s been a recommendation of the American College of Obstetricians and Gynecologists for years, however a prenatal health and nutrition survey of U.S. women performed on behalf of the March of Dimes in 2017 found just 34 percent of women said they started taking the prenatal vitamin or multivitamin before they knew they were pregnant.
Most providers agree that if you’re of “childbearing age” and thinking about getting pregnant, now is the time to start popping a prenatal vitamin.
Another bonus? Some studies indicate that taking prenatal vitamins may actually reduce baby’s risk of autism. Researchers at the University of California, Davis, followed 700 California families with children from 2003 to 2009. Their study, published in the medical journal Epidemiology in 2011, claims that “women who reported not taking a daily prenatal vitamin immediately before and during the first month of pregnancy were nearly twice as likely to have a child with an autism spectrum disorder as women who did take the supplements—and the associated risk rose to seven times as great when combined with a high-risk genetic make-up.”
[pullquote align=”center”]“Facing this array of side effects, many women are reluctant to take their vitamin regularly, if at all.”
—Bradley Price, MD[/pullquote]
A second study, published in the British Medical Journal in 2017, looked at more than 270,000 kids born in Stockholm, Sweden, between 1996 and 2007. Researchers say they found that women who take prenatal vitamins during their pregnancy may be able to lower their child’s risk of developing autism associated with intellectual disabilities by as much as 30 percent.
Of course, correlation does not equal causation, and other studies have purported that too much of two specific vitamins—B12 and folate—during pregnancy may have the opposite effect!
Still, doctors stress the need to take prenatal vitamins because of what they definitely do know, thanks to other studies.
“We do know that taking folic acid supplementation prior to conception decreases the risk of having a baby born with a neural tube defect, such as spina bifida,” says Mary Jane Minkin, an OB-GYN and clinical professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the Yale University School of Medicine.
“We do know that babies in utero take iron from their moms—and if mom is anemic to begin with, she will likely become more anemic—and feel even more exhausted,” Minkin says. “We know that vitamin D is important for many organ systems to work properly. So a good prenatal contains proper amounts of all of those vitamins.”

How to Choose the Best Prenatal Vitamin

Before you hit the vitamin aisle at your local pharmacy, your best bet for finding the best prenatal vitamin for you is a trip to your OB-GYN or midwife’s office. They can test your blood to see what your iron and other levels look like and help you determine what nutrients you really need right now.
Some doctors advocate for a prescription-strength prenatal vitamin, as they typically have different amounts of folic acid than the kinds you’ll find in the store.
While an over-the-counter prenatal vitamin will likely contain about 800 mcg (micrograms) of folate, you’ll find about 1,000 mcg in prescription prenatals, Price says.
“But the key difference is the iron source,” he adds. “OTC sources typically contain iron salts, such as ferrous sulfate, gluconate, or fumarate, which are all poorly absorbed and aggravate acid reflux, leading to nausea, indigestion, heartburn, and constipation. Facing this array of side effects, many women are reluctant to take their vitamin regularly, if at all.”
Price recommends Prenate Mini, a prescription-strength prenatal vitamin that puts the iron molecule between two amino acids, so it’s absorbed efficiently in the same part of the small intestine as amino acids.
But other women may find that an OTC option works for them, says Manglani. “There is a huge selection to choose from when selecting an OTC vitamin,” she says. “This gives you a lot of choice, but it is also important to make sure you select a prenatal vitamin that has all the necessary nutrients.”

What to Look for in a Prenatal Vitamin

To ensure you do select the right prenatal vitamin, Manglani suggests you look for a one that includes the following, or that you take a vitamin that includes some of these ingredients, along with supplements that your healthcare provider approves.

Methyl-folate

Compared to folic acid, Manglani says methyl-folate is better absorbed by the body but still provides the necessary nutrients. The recommended intake is between 400 and 1,000 mcg per day.

Iron

This mineral will help mom stay healthy, Price says, and it will also help your body as it works to produce more blood to pump through the body and carry oxygen to the baby. Look for a vitamin that delivers 30 mg per day.

Vitamin A

The recommended daily intake of vitamin A is 770 mcg, and this is not a case of “770 is good, so more is better.” Manglani advises moms-to-be to be wary of anything with more than 5000 IU (short for International Unit), as vitamin A toxicity can lead to birth defects.

Vitamin D

It’s recommended that you get at least 400 units of vitamin D, a fat-soluble vitamin that’s typically found in fish and dairy products, a day. Most adults also get vitamin D from spending time in the sun. Because it’s recommended that parents keep newborns out of direct sunlight to protect their fragile skin, recent studies have shown a risk of vitamin D deficiency in babies. Consuming vitamin D in your prenatal vitamin has not only been linked to a reduction in the risk of pre-eclampsia during pregnancy, but it helps boost baby’s vitamin D levels.

Calcium

Moms-to-be should shoot for at least 1,000 mg per day, Manglani says. This will help the fetal skeleton develop, and it can be obtained via your prenatal vitamins and the consumption of calcium-rich foods such as yogurt and milk.

Iodine

Because of the impact pregnancy can have on the thyroid gland, the American Thyroid Association recommends iodine supplementation before and during pregnancy as well as while breastfeeding. Look for a supplement with about 150 mcg per serving.

Choline and DHA (Docosahexaenoic Acid)

Thought by scientists to help improve a baby’s brain development, these nutrients are not always available in prenatal vitamin form and may require an extra supplement, Manglani says. You can check with your provider to see if there is one that’s good for you. The recommended level of DHA is 200 to 300 mcg, while it’s suggested you get about 450 mgs of choline.

When Prenatal Vitamins Aren’t Worth It

In addition to making sure your prenatal vitamin has those ingredients outlined above, there are also a few other things to watch out for. Buying the wrong prenatal vitamin might not be worth it. Here’s what the experts recommend:
You’ll want to make sure any bottle of vitamins you’re considering has been thoroughly reviewed by reputable agencies, warns Vin Amin, president of vitamin maker Eu Natural.
“Look to see that the supplement has been made to meet FDA standards and cGMP, which stands for current Good Manufacturing Practices,” Amin suggests. “This ensures your product has been manufactured and packaged based on the latest regulations.”
[pullquote align=”center”]Prescription vitamins may be covered by your health insurance. That could net out to a cheaper or even free prenatal vitamin.[/pullquote]
You’ll also want to be wary of junk “fillers” added to a prenatal vitamin, Amin warns. Check the supplement facts panel in the “other ingredients” section on the bottle. If you spot magnesium stearate, titanium dioxide, or silicon dioxide, you know you’ve picked up a vitamin packed with fillers.
If you’re a vegetarian, you should also beware that many prenatal vitamins come in gelatin capsule form, which means they’ve been made from animal products. “Vegetarians will definitely want to avoid these products,” Amin says.
And while it’s tempting to load up on gummy vitamins (hey, who says the kids get to have all the fun?), Amin says they’re not as potent as the capsule formulation, which means a whole lot of extra sugar intake to get the same dosage.
One final thing to consider, Manglani says, is cost. While over-the-counter prenatals are cheaper for some and may be the best bet if your provider recommends an OTC vitamin, prescription vitamins may be covered by your health insurance. That could net out to a cheaper or even free prenatal vitamin, Manglani says.

Prenatals Without the Pain: Treating Nausea From Prenatal Vitamins

Some 97 percent of women do take prenatal vitamins during pregnancy according to the March of Dimes poll—which is good news—but while they should be taken all the way through pregnancy and even while breastfeeding, that doesn’t always happen.
The culprit is often nausea, says Sherry Ross, an OB-GYN at Providence Saint John’s Health Center in Santa Monica, California.
“With the high amounts of vitamins and minerals, prenatal vitamins are notorious for causing nausea during pregnancy,” Ross says.
To help quell the nausea and stick to your prenatal vitamin routine, she suggests taking your vitamins right after eating or before going to sleep at night. It’s also okay to cut that vitamin in half (many are scored for this purpose), taking half in the morning and half at night.
“If the nausea persists, I have my patients take a one-a-day multivitamin instead of a prenatal until they have a stronger stomach,” she says. Changing brands may also be a helpful option!

Categories
Mom x Body Motherhood

These Are The Foods To Avoid While Breastfeeding (According To Experts)

As a new mama to your little peanut, you want to give the very best to their growing body. But it’s not that simple when your baby is gassy and fussy and you feel like you’ve tried everything to make them happier. Your pediatrician or even well-meaning friends may ask you if you’ve tried cutting out every food under the sun to see if that helps.
Not sure which foods might be having some adverse effects on your little one?
Luckily, most foods are still on the table while you’re breastfeeding. But there are some that should be avoided, because your diet should be about keeping your baby safe while still giving them all of the nutrients they need.
But maybe your little one is doing just fine, and you’re not so concerned about which foods to steer away from. Instead, you may be wondering, “What foods are good to eat while breastfeeding?” Whether you want to increase your milk supply or just ensure you’re being as healthy as possible, we talked to experts to get the deets on those foods too.
We asked a lactation counselor and two registered dietitians about the foods to avoid while breastfeeding—and the ones to pack into your diet.

Which Foods to Avoid While Breastfeeding

Determining which foods to avoid can be tricky, especially since searching the topic online can produce a variety of conflicting results.
“Make sure your information is coming from a valid source. Look at the credentials and licensure of anything you read or hear,” says certified lactation counselor Katie Halloran of Grand Rapids, Michigan. If you can’t find a clear answer online, Halloran recommends talking with your healthcare provider or a lactation consultant.

Avoid: High-Mercury Seafood

“It’s important to avoid all high-mercury fish, such as shark, swordfish, king mackerel, and tilefish, because mercury can be harmful to a developing baby,” explains Amy Gorin, registered dietitian nutritionist and owner of Amy Gorin Nutrition in the New York City area.
She says that “You can safely eat up to 12 ounces a week of lower-mercury fish, such as salmon, sardines, and anchovies, or 6 ounces of moderate-mercury fish, such as halibut and albacore tuna.”

Avoid: Certain Herbs and Herbal Supplements

Just because something is “all-natural” doesn’t mean it’s good for you and your precious little human.
[pullquote align=”center”]“Before you take any herbs, even if you hear it increases milk supply, talk first with your physician and your baby’s pediatrician.
Katie Halloran, APR, CLC
[/pullquote]
“Herbs can have pharmacological side effects. So before you take any herbs, even if you hear it increases milk supply, talk first with your physician and your baby’s pediatrician. You want to ensure it doesn’t counteract with your medications or your health or your baby’s,” Halloran says.

Avoid: Too Much Caffeine

As a general rule, you shouldn’t give your baby what you shouldn’t be giving yourself anyway, like too much caffeine, says Halloran. But she does say that “If you drink some caffeine, that shouldn’t deter you from breastfeeding.”
The U.S. Department of Health and Human Services Office on Women’s Health states that “Drinking a moderate amount (one or two cups a day) of coffee or other caffeinated beverages does not cause a problem for most breastfeeding babies. Too much caffeine can cause the baby to be fussy or not sleep well.
So, no need to fret: Your morning latte can still be your energy lifesaver! Just think twice about having a cup every hour.

Avoid: Too Much Alcohol

Can’t breastfeeding mamas treat themselves to a glass of wine? The answer is yes. (And thank goodness for that!)
An Australian study showed that “low level drinking during breastfeeding is not linked with shorter breastfeeding duration or adverse outcomes in infants up to 12 months of age.”
“If you decide to drink, wait to breastfeed until the alcohol has cleared from your breast milk,” Gorin says. “This usually takes two to three hours for one alcoholic beverage (one 5-ounce glass of wine, one 12-ounce beer, or 1.5 ounces of liquor).”
Halloran agrees, saying that alcohol isn’t trapped in the breast milk, so pumping and dumping won’t remove the alcohol: “It simply takes time to get out of your system, just like it does your blood alcohol levels.”

Sushi and Breastfeeding: Is It Safe?

Time to celebrate another “yes”!
“Breastfeeding moms can eat any type of sushi, except poisonous blowfish, which probably no one should be eating,” says Kathy Kimbrough, registered dietitian at iLiveWell Nutrition in Austin, Texas.
Kimbrough says the challenge is that we never know when we will get food poisoning or what may cause it. “The best way is to be mindful of safe food-handling practices including hand-washing and ensuring proper temperatures for food storage. Eating fully cooked meats is one way to minimize risk. That said, I myself enjoy eating sushi and raw oysters occasionally, and I’m breastfeeding,” she explains.

Foods to Avoid While Breastfeeding to Prevent Colic

Why some babies are colicky sadly remains a mystery to doctors (and parents)—and it appears that the best cure is time. “Colic will likely improve or disappear by 3 or 4 months from birth,” says the Office on Women’s Health.
While changing your diet can sometimes help your colicky baby, holding or soothing your baby might also be the answer. “Eating regularly is the best ammunition for dealing with colic. Burp them consistently. Educate yourself on tummy massages and bicycling the legs to help their little belly pass gas,” encourages Kimbrough.

Common Causes of Fussy, Gassy Babies

As a dietitian and breastfeeding mom, Kimbrough finds that many women cut out certain foods, like spicy foods or dairy, if their baby is fussy or gassy. “In reality, there are very few things that actually cross over to the breast milk from the mother’s diet that makes them gassy,” she says.
But a protein or dairy allergy is different. “An allergy can manifest in many ways, and usually it’s pretty extreme. The stool will be green or contain mucus or blood, so it’s obvious something is wrong.”
[pullquote align=”center”]“Remember to take care of yourself by eating well and eating regularly so you can take care of your baby.”
—Kathy Kimbrough, RD[/pullquote]
Most babies, though, (unfortunately) will be gassy from time to time. This is normal: They have brand new bodies and digestive systems.
And it’s natural for moms to want to fix our baby’s irritability, but changing and limiting your diet can just be more challenging and stressful for everyone.
An elimination diet is not often the answer. “Remember to take care of yourself by eating well and eating regularly so you can take care of your baby,” says Kimbrough.

What to Eat While Breastfeeding

Thank goodness the menu is large when you’re breastfeeding!
Here are the key points to know.

Focus on a well-rounded diet.

“In order to nourish your baby, you have to nourish yourself. Aim for eating every 2 to 3 hours (just like baby!),” says Kimbrough. “Try to include carbohydrates, protein, and fat with a vegetable or a piece of fruit at each meal. And pair carbohydrates with protein for snacks. This balance will help your blood sugar remain within healthy fluctuations and keep your energy levels up.”
But Kimbrough reminds new moms to give themselves grace. “There were many times I wanted to stop breastfeeding because I was so tired. It can be really isolating when all you feel like you’re doing is pumping and breastfeeding.”
So go easy on yourself. Make simple meals, and don’t beat yourself up if you buy pre-chopped vegetables or packets of oatmeal instead of making it yourself on the stovetop.

Include fatty fish (in moderation).

Give your baby all of the powerful nutrients you can!
“Fatty fish such as salmon provides beneficial omega-3s to your baby,” says Gorin. So get cooking some tasty salmon recipes (or better yet, have your partner help).

Drink plenty of water.

“Hydration is very important for breastfeeding moms. You need extra water because your body uses water to produce breast milk,” shares Gorin. “It’s a good idea to drink a glass of water each time you nurse.”
In addition to having your water bottle nearly joined to your hip, hydrate your body more by eating water-rich foods such as fruits, vegetables, and soup, says Gorin.

Galactagogues: Foods That Increase Milk Supply

While many clinicians recommend continued use of prenatal vitamins during breastfeeding, there’s less consensus on the foods and herbs that increase milk supply.
“There are some foods that [are often said to increase] your milk supply, like milk thistle, oatmeal, fenugreek, and brewer’s yeast,” says Kimbrough. These supplements and herbs are commonly called galactagogues.
“Research indicates there are no long-term effects of increased milk supply for galactagogues,” explains Halloran. Unfortunately, there’s not much evidence of any food or herb being a magic bullet for increasing milk supply.
The best ways to maintain your milk supply are eating enough calories and drinking enough water, says Kimbrough. The American College of Obstetricians and Gynecologists states that your body needs about 450 to 500 extra calories per day to make breast milk, meaning you really need to get those nutrients in to keep your supply up.
But even if you’re eating well and drinking enough water, you can still struggle with having enough breast milk or getting your baby to breastfeed often enough. And that’s where additional resources come in.
If you’re having trouble breastfeeding or feel your supply isn’t where it needs to be, seek assistance sooner rather than later, says Halloran.
Many hospitals employ lactation consultants who can offer you techniques and personalized guidance. And many communities host breastfeeding support groups. “A breastfeeding group allows you to talk about successes and challenges with other breastfeeding moms and get that extra support,” shares Kimbrough.
Don’t live close enough to a support group or a lactation consultant? Call The Office on Women’s Health Helpline from anywhere in the U.S., Monday through Friday, 9 a.m–6 p.m. ET at 800-994-9662.

Categories
More Than Mom Motherhood

Babymoon Do's And Don'ts: How To Get The Most Out Of A Pre-Baby Trip

My husband and I had two weddings—the first was a tiny ceremony with 15 guests in upstate New York. The second, almost eight months later, was a big affair in Brooklyn. For the second one, I was almost five months pregnant.
When I got pregnant, we lived in Vienna, Austria, but we’d always planned to have our wedding in New York City, where I’d lived for over a decade. I missed my friends horribly and wanted as many people to come as possible. So we traveled to our own wedding—and spent almost a month in town.
The result wasn’t exactly a traditional babymoon, but it was exactly what we needed: time to reconnect with old friends, visit my old haunts, and have time together outside the stress of our new life abroad.
This is all to say: A babymoon can be anything, as long as it’s time set aside for the two of you before the madness of parenting sets in. You can tailor it to your needs and desires. Consider it a Last Supper à deux.

Why take a babymoon?

Why not? is the real question. If you can afford it, it’s totally worth it.
I definitely think it’s important to connect just with your partner right before the madness and complete loss of privacy begins,” says Isaac Butler, dad of one in New York City, who traveled with his wife to Montreal before their daughter arrived.
[pullquote align=”center”]“It’s a time for the couple to focus on themselves and their partnership before another being will enter their world. Since this will change the dyad forever, they can recall the connection they felt during babymoon when having difficult times.”
—Vanessa Katz, PhD, clinical psychologist[/pullquote]
The destination is not the most important factor. Yes, it can be a chance to go to that place you’ve long dreamed of visiting and you know will be a pain with kids—Paris! London! Venice!—but it can also just be a weekend staycation where you can be tourists in your own city or town.
What’s important are the moments spent together: “It’s a time for the couple to focus on themselves and their partnership before another being will enter their world,” explains Vanessa Katz, PhD, clinical psychologist in L.A. “Since this will change the dyad forever, they can recall the connection they felt during babymoon when having difficult times.”

When to Take a Babymoon

Most couples take off during the second trimester when nausea has (usually) abated and before travel becomes impossible. The American College of Gynecology and Obstetrics states that traveling after 36 weeks is no longer safe.

Babymoon Planning Guidelines

Make it simple.

“It was important that the logistics be easy: wake up, get on train, get off train, you are there,” says Julie Dawson, who traveled from Vienna, Austria, to Venice, Italy, with her husband during her second trimester. “It needed to be a place where you could plan or not plan and there was always plenty to see; a place where you could eat excellent food and drink fizzy wine (for the papa) all the time. We love looking at the photos today—also I remember thinking it would be a horrible place to visit with a stroller—too many bridges with stairs—so figured we wouldn’t be back for a long time, which seems to be coming true.”

Make it romantic.

While romance might be the last thing on your pregnant-mama mind, leaning into the intimacy of a vacation with your partner before baby is a great way to connect, while it’s still just the two of you. Think back to what you enjoyed when you first started dating, and recreate that on your babymoon. “It needs to feel like a real getaway [that] offers stuff you love. For us it was eating, relaxation, and nature,” says babymoon-goer Jessica Latiff.

Consider bringing friends—really!

A babymoon doesn’t have to be full of one-on-one romance, though. It can also be a time to just enjoy life—kidless. A great way to do that is to spend time with your closest pals—who won’t mind if you head to bed at 8 p.m. We went to Guerneville [in Sonoma County, California] and rented a cabin,” says Molly Benson, who decided to extend her babymoon invites beyond just her partner. “Some friends came for a few days too. We rented a boat and paddled for four hours and took our dog on the boat. It was ridiculous and fantastic.”

How to Babymoon Safely

Don’t travel too far.

This is by no means a rule, but most pregnant women are not eager to sit on a plane for 10 hours. (That said, many are keen to use their passports for the last time in a while!)

Keep it moving.

Whether you’re on a plane, train, or car, make sure you get up to move your body. This is especially important on planes where you can get blood clots. Consider wearing compression socks.

Keep your OB in the loop.

It’s not a bad idea to have your OB weigh in on travel plans—or at least let her know you will be away and where you plan to go.

Check out medical facilities in your chosen destination.

Obviously this shouldn’t be an issue if you’re going to a big city, but this is worth looking into if you’re going on an adventure or abroad. If your OB gives the okay, well, you’re probably okay, but it’s best to be prepared.

Do you have travel health insurance?

Insurance companies can be really nasty when it comes to maternity coverage while traveling. Check in with your insurance provider, and consider buying additional travel health insurance.

Babymoon Destinations: Where to Go (and Where to Avoid)

Where you go is, of course, entirely dependent on you! Here are a few tried and true suggestions.
[pullquote align=center]You won’t vacation like this for a while, so enjoy it.[/pullquote]

Babymoon in a City

Montreal, New York, Nashville, L.A., Paris, Venice, Rome, Buenos Aires, Rio—you choose. The point of going to a city is that you’ll have ample opportunities for all the things that will become difficult with kids: long, leisurely brunches; wandering (quietly!) through museums; sightseeing; concerts; plays. You get the picture. None of this is particularly kid-friendly, and it’s great.

Babymoon in the Country

Fresh air, peace and quiet, no distraction? Bliss. “We went to upstate New York because it was within driving distance. I was high risk,” says Kelly Smith. “My only requirement was that it had to have a pool. I stood or floated in that damn pool for like, five or six hours a day for four days. It was glorious.”

Babymoon at a Resort

Who doesn’t want to just lie around at the beach and/or a spa? From the beaches of Florida to the quiet of Stowe, Vermont, to the cliffs of Big Sur, all the way to the Turks and Caicos, hitting an all-inclusive is a true way to indulge. True, you can’t partake in the limitless alcohol, but the constant array of delicious food and spa treatments is heaven for a mama-to-be.

Babymoon Packages

Don’t want to plan anything? No worries! Plenty of companies now offer babymoon packages, mostly at resorts. The advantages? Some include early check-in, massages, room service, and other upgrades on the cheap(er).

A Word of Warning

Don’t go anywhere where there is a threat of Zika. Zika is carried by mosquitoes and can cause serious birth defects. You can check the Centers for Disease Control for up-to-date travel advisory warnings.

Babymoon Tips and Tricks

Get travel insurance.

What if the nausea doesn’t abate by week 14? You might not want to travel across the world.

Think smart.

Don’t go on a cheese tour if you won’t be able to eat 99 percent of the cheeses. Same goes for a wine tour.

Once you’ve booked it, don’t worry about the cost.

Don’t ruin your last chance in a while to indulge yourself by obsessing about the money you’re spending. You won’t vacation like this for a while, so enjoy it.

Stay on top of your symptoms.

Chances are you’ll have the time of your life, but it’s important to be mindful of how your body is feeling. Check in with your OB if you feel like anything is awry.

Turn off that phone.

This is a time for you and your love! Set social media aside and enjoy the sweet time together.

Categories
Mindful Parenting Motherhood

How To Read Your Baby (And Gain Their Trust)

For parents of a new baby, deciphering what they need based on a series of subtle cues and seemingly identical cries can be overwhelming. As a new mom, I found a lot of comfort in developing a pattern of feed, sleep, and play, with diaper changes sprinkled in the mix, but there were still plenty of instances when I found myself confused to the point of tears.

HealthyWay
iStock.com/SolStock

It often felt like nothing I tried would calm my baby or help her drift to sleep. With time, I learned that my baby was actually an excellent communicator—I simply needed to learn to watch for patterns in how she expressed her needs. My daughter wasn’t extraordinary; babies actually begin communicating with their parents from a very young age. Want to learn how to read your baby? Here’s what you need to know.

The Development of Communication

The foundation of communication is being built long before babies are born, according to Ayelet Marinovich, pediatric speech-language pathologist and parent educator.
“We know that even babies in utero are starting to use their sense of hearing,” she says. “So they’re listening to things like the components of speech and the melody of the language or languages.”

HealthyWay
iSTock.com/NataliaDeriabina

This learning begins around 20 weeks into the pregnancy.
From birth, developing children tend to hit specific communication milestones, both verbal and nonverbal. One of those first milestones, seen roughly around 6 weeks post-birth, is a social smile. The baby observes someone smiling at them and returns the smile, noting that their smile evokes a positive response from the recipient.
“They can recognize … ‘Oh! That gets a response,’” Marinovich says, noting that crying functions very similarly, with babies learning quickly what their cries achieve.
HealthyWay
iStock.com/damircudic

At 4 to 6 months, babies coo, indicating that they are learning vowel sounds. This is followed by babbling, which is all about learning to use vowels and consonant combinations. At 9 months, babies begin using gestures to draw attention to things.
And around 12 months, the first words are spoken.

Listening and Watching for Subtle Cues

A year is a long time to parent a baby without the assistance of words. The good news is that words aren’t the only form of communication, and babies use crying, body language, and facial expression to give voice to what they want and need most from their caregivers.

I’m hungry!

Although many babies cry if they’re hungry, most babies start dropping hints long before things feel urgent enough for tears. Cries are actually not considered hunger cues; instead, they signal distress, according to WIC Works (link opens a PDF), a project of the United States Department of Agriculture. According to this resource, parents can avoid distressing hunger in their children by learning patterns and subtle cues babies use to draw attention to their hunger.

Photo of baby holding a bottle looking up
iStock.com/romrodinka

In newborn babies, rooting around for the breast, sucking on their hands or fingers, and drawing their hands to their face are all signals of hunger. Most babies also open and close their mouth when they’re ready for a meal.
Hungry baby has their fingers in their mouth
iStock.com/BogdanVj

Typically, babies are ready for solid foods once they are sitting up on their own. Parents can gauge their baby’s interest in solid foods by watching for common signs like reaching for what is on their parents’ plate or the ability to handle foods without pushing them out of their mouths.

I’m full!

Just like babies signal their parents when they are hungry, they also communicate when they are satisfied. This is an interesting and important topic, as properly reading infant cues on hunger and satiety is considered part of obesity prevention. It helps avoid over-consumption, according to a research review in the journal Maternal & Child Nutrition.

Baby is being fed and falling asleep
iStock.com/BraunS

Newborns typically slow their sucking or even fall asleep when they are satisfied, according to WIC Works. They may turn their head away and appear more relaxed. As babies grow older, they become distracted or want to play while eating. Some babies clamp their mouth shut to refuse a bottle or breast.

I’m tired!

If you’ve ever cared for an infant, you know there is such thing as an overtired baby. Some babies become so exhausted it is actually more difficult to get them to sleep. Watching for cues that your baby is ready for a nap or bedtime can make the whole experience less dramatic for everyone involved—saving you from a bedtime struggle or hysterical crying from a wiped out baby.

Overtired baby is crying in crib
iStock.com/FamVeld

Most obvious, perhaps, is that newborns yawn when tired. They also pull their hands to their face, clench their hands into fists, rub their eyes, or pull at their ears, according to Today. As babies grow more tired, their movements become jerkier and they become less interested in their surroundings.
Catch sleepiness early, use a routine to make naps simple and predictable, and encourage healthy sleep habits in developing babies.

I need quiet.

From a young age, babies drop hints when their environment has become too much for them. Like older children and adults, babies need quiet and breaks from stimulation.
“Maybe they’re closing their eyes,” says Marinovich. “Or they’re crying for ‘no apparent reason.’”

Overstimulated baby is having quiet time
iStock.com/Pekic

Many babies will also look away, wave their hands, or kick their feet if they’re becoming overstimulated. The solution to overstimulation is as simple as making an adjustment to their environment like lowering or removing noise, stepping away from them for a time, or lowering the lights in the room.

I want to play.

One of the primary jobs that comes with being a baby is learning by interacting with their brand new environment, according to Marinovich.
“The baby is in this sensory world, they’re all of a sudden exposed to noise and everything they’re seeing and everything they’re touching,” she says. “This is a very different environment than what they had in the womb.”

baby sitting on floor looking up
iStock.com/Westersoe

As they watch, listen, and learn, babies are focused on finding patterns in their environment and indications of what deserves their attention, Marinovich explains. Having a parent present and close gives them an opportunity to learn through interaction.
Baby is learning by playing
iStock.com/LSOphoto

Of course, newborns don’t exactly toss a ball or drag out a train set when they’re looking for a little one-on-one with their caregiver. How can you know when they’re up for some interaction? According to Marinovich, babies indicate this even within their first week of life by settling into an awake, but calm, state of being.
“Babies sort of have these patterns of alertness and quiet,” she says.

I’m in pain.

Babies do so much crying, it is difficult to determine what their cries mean exactly. Are they tired and hungry, or is something causing them pain? Crying that indicates pain escalates in intensity and doesn’t resolve with comfort or food. A cry caused by pain may also have a higher pitch than usual, according to Kyla Boyse, RN, of the University of Michigan.

Baby in pain and distress is crying
iStock.com/damircudic

Parents can also watch for body language typically associated with pain. Infants in pain scrunch up their faces, and their body may become tense. Determining the source of pain is difficult, but a common cause is gas or an upset stomach. If you are concerned about your baby, a doctor can help determine what is causing the pain and if further treatment is necessary.

Encouraging Strong Lines of Communication

A strong bond between an infant and their caregiver is foundational to their emotional and physical health. One popular school of thought on child attachment, developed by German psychologist Erik Erikson, argues that the first lesson children must learn is that the world and the people around them are trustworthy. For this reason, understanding how to read your baby and responding to their needs is an important part of building a healthy relationship with your child.

Mom holds her baby and smiles
iStock.com/kate_sept2004

The good news is that encouraging strong lines of communication with an infant or young child isn’t rocket science—it’s really about being present and consistently tuned in to their needs. Marinovich strongly believes that parents are already equipped with the tools they need to bond with their baby, and she says many parents are already doing many of the things necessary to encourage communication.
Mom holding her baby
iStock.com/SolStock

“We tend to overcomplicate things,” admits Marinovich. “We can see how they are communicating by these early cries … we can offer comfort through things like our touch and smell and voice and milk.”
[pullquote align=”center”]”[Take] a moment while you’re changing a diaper or while you’re nursing, to get into a comfortable position, to make eye contact, to include a moment of touch on your baby’s skin. We already have the materials we need.”
—Ayelet Marinovich, pediatric speech-language pathologist and parent educator[/pullquote]
One specific example is the use of infant-directed speech, which is often referred to as motherese. Listen to yourself talk to a baby for even a few seconds, and you’ll probably hear it—you may slow down your speech, speak in a higher pitch, or add a kind of sing-songy component to your speech. This habit is universal, according to Marinovich, and doing so encourages more attention from infants.
Mom holding her baby and talking
iStock.com/PeopleImages

There is also research published in the journal Infancy that suggests infant-directed speech contributes to language acquisitions and is specifically helpful for learning the skill of word segmentation.
Lastly, consistent communication with your newborn can easily be included in your routine. Think about the things you do day in and day out with your baby and how talking and play could be introduced into those tasks.
“[Take] a moment while you’re changing a diaper or while you’re nursing, to get into a comfortable position, to make eye contact, to include a moment of touch on your baby’s skin,” encourages Marinovich. “We already have the materials we need.”

Categories
Healthy Pregnancy Motherhood

Braxton Hicks Contractions Versus The Real Deal

Pregnancy is hard. Another person is literally growing inside of you, pregnancy hormones have your body and emotions all over the place, and you know your feet are still attached to your legs even though you haven’t seen them in weeks. As if that’s not enough, Mother Nature decided to throw in a curve ball with Braxton Hicks contractions.
Braxton Hicks, put shortly, are your body’s way of warming up for labor. But how do you know if you’re experiencing real contractions or the practice variety?
We spoke to OB-GYNs Janelle Cooper, MD, at Baltimore’s Mercy Medical Center and Chase White, MD, at the Department of Obstetrics and Gynecology at Einstein Medical Center in Philadelphia, to find out everything you need to know about Braxton Hicks contractions.

What are Braxton Hicks contractions?

“Braxton Hicks contractions are contractions that happen before the onset of labor. They can also be defined as contractions that occur in the third trimester that usually do not result in cervical dilation,” says Cooper. “The uterus is made of muscle tissue, and naturally muscles will contract from time to time, so Braxton Hicks can be felt earlier in pregnancy, sometimes even early in the second trimester.”

In addition, Braxton Hicks may actually help prep the uterus for labor.

“Braxton Hicks contractions may be a part of the process of remodeling the uterus in preparation for labor,” White explains. “Later in the third trimester, the irregular contractions that many women experience are not only the classic disorganized ‘Braxton Hicks’ contractions, but are actually normal, effective contractions. They occur infrequently at first, becoming more frequent as the pregnancy progresses. They start the process of cervical shortening, softening, and opening that ultimately results in active labor and then birth.”

What do Braxton Hicks feel like?

Some women describe Braxton Hicks contractions as feeling sort of like your abdomen suddenly tightens all over: not exactly painful, but not all that comfortable either. Others describe it more as a cramping sensation.
And according to Cooper, some of her patients have said Braxton Hicks contractions feel like “[the] baby is balling up tightly and then releasing the position.”

How will I know the difference between Braxton Hicks and real contractions?

Oh, you’ll know, my sweet little starfish. But just in case you don’t, there are some key differences between Braxton Hicks and real contractions.
Typically, Braxton Hicks contractions:

  • Are irregular and pretty infrequent. You may have several Braxton Hicks contractions in a row and then nothing for several days. Or you may have Braxton Hicks contractions once or twice a day but nothing that can be timed regularly.
  • Do not increase in intensity. As mentioned before, Braxton Hicks are usually uncomfortable—not painful—and they don’t increase in intensity as they occur.
  • Frequently disappear with no warning. Braxton Hicks are just as likely to stop with no warning as they are to start.

On the other hand, real contractions are pretty much the opposite of Braxton Hicks. Real contractions can be regularly timed, increase with intensity, and are most definitely painful as they progress.
Every woman is different, of course, but most women (myself included!) report real contractions to feel like the worst period cramps of your life rather than an abdominal tightening sensation.

Causes of Braxton Hicks Contractions

“Certain factors, like not drinking enough water throughout the day, or abdominal trauma as in a car accident, can trigger Braxton Hicks,” says Cooper. In addition, Braxton Hicks can be triggered by overexertion and even orgasm!
Before you throw your bag in the car and rush to the hospital, though, there are a couple of tricks you can try to test whether you’re experiencing Braxton Hicks contractions or the real deal.

  • Dehydration is a big trigger for Braxton Hicks. If you’re experiencing these practice contractions, first try drinking a big glass of water to see if they subside.
  • Sometimes you can experience Braxton Hicks if you’ve overdone it, say in a prenatal fitness class or just working around the house. If you feel that familiar tightening, take a break. Put your feet up, relax, and put on an episode of The Office.
  • Braxton Hicks can also be caused by a full bladder. If it’s been a while since you had a bathroom break, and you’re experiencing irregular contractions, take a pee break.
  • Sex can also trigger false contractions, since orgasm stimulates the uterus. Now, I don’t recommend you stop having sex (or orgasms!), but taking a short bath (30 minutes or less) after sex may help alleviate Braxton Hicks contractions.

Braxton Hicks Contractions and False Labor

Let’s recap: Typically, Braxton Hicks contractions are fairly painless, irregular, and can often be alleviated by drinking a glass of water or resting. But sometimes—especially as you near your due date—Braxton Hicks can mimic real contractions pretty darn well, which is known as false labor.
[pullquote align=”center”]“The onset of preterm labor can be subtle, and it is sometimes impossible to distinguish between normal uterine irritability, like Braxton Hicks, and true preterm labor without a physical exam or other tests.
—Chase White, MD[/pullquote]
During false labor, your contractions may come more quickly, are more painful, and may even increase in intensity. White says the difference is that false labor can actually contribute to cervical ripening and dilation, which could lead to preterm labor.
“If you are still preterm (before 37 weeks) but the contractions are coming frequently (I use 4 or more contractions per hour as my threshold), it is essential that you speak to your OB-GYN and come in to be evaluated,” White cautions. “The onset of preterm labor can be subtle, and it is sometimes impossible to distinguish between normal uterine irritability, like Braxton Hicks, and true preterm labor without a physical exam or other tests.”
To determine whether you’re really in labor, your doctor will probably recommend that you bypass the office and head straight to the hospital. Once you’re there, you’ll get hooked up to a fetal monitor to check on baby, and you’ll probably have a cervical check to see if you’re dilated.
White prefers to think of these kinds of contractions as “early labor” when it occurs at term. He continues, “These regular contractions are not the disorganized uterine contractions that classically we call ‘Braxton Hicks.’ Rather, they are part of the preparation for active labor.  While they will sometimes abate on their own, sometimes they will become progressively more frequent and then transition into active labor.”

Braxton Hicks Q+A With Janelle Cooper, MD

I get Braxton Hicks every time I exercise. Should I stop working out?

“Exercise is great in pregnancy, but if you’re in pain, or having Braxton Hicks, you may want to stop at that time and consider a decrease in the intensity or length of your workouts going forward.”

Are you sure Braxton Hicks contractions don’t lead to labor?

“They don’t lead to labor. Think of Braxton Hicks as a dress rehearsal for labor.” The dress rehearsal comes before the show, but really, it’s just practice.

I know Braxton Hicks are supposed to be painless, but can they cause pelvic pain and cramping?

Generally, they are painless. But they can be painful and may cause any discomforts of pregnancy (back pain, hip pain, vaginal pain or pressure) to amplify, resulting in additional pelvic pain and possibly cramping.”

Can you please tell my partner that frequent back rubs are proven to alleviate Braxton Hicks?

“Back rubs (or foot rubs) from a partner help to calm and soothe overall and may distract from the contractions, so I’d recommend trying it!”