News Moms Need

We have long said, and still do, that breastmilk is best for infants. It is full of important minerals and nutrients to help your little one grow. Unfortunately, however, it doesn’t contain enough vitamin D to meet the American Academy of Pediatrics guidelines.

Vitamin D is needed to absorb calcium and phosphorus. Breastfed babies need an additional 400 IU of vitamin D each day until they’re weaned to fortified formula and can drink at least one liter (about 4 ¼ cups) every day. Starting at age 1, babies drinking plenty of milk fortified with vitamin D may no longer need a vitamin D supplement.

As your children grow and start eating solids, include foods that are rich in vitamin D, like fatty fish, eggs, and milk. But be aware that older children and even adults have a hard time getting the recommended levels of the vitamin through food alone.  Check with your child’s doc to see if she should take a supplement with 400 IU to 600 IU. That amount is often included in chewable multivitamins which most kids like taking. Children with some chronic diseases such as cystic fibrosis may be at increased risk for vitamin D deficiency and may need an even higher dose in a supplement.

You may have heard that the body makes its own vitamin D when exposed to ultraviolet B (UBV) rays from the sun. While true, sun exposure can be hazardous to baby’s skin and the American Academy of Pediatrics recommends that children under the age of 6 months avoid sun exposure. All other children and adults need to slather on the sunscreen throughout the day which can block the production of vitamin D. Pregnant women have particularly sensitive skin and should pay attention to sunscreen.

Important note: Be sure not to give too much vitamin D to babies. More of a good thing often is not good. High doses can cause a host of symptoms including nausea, vomiting, loss of appetite, excessive thirst, muscle aches, or more serious symptoms. Some researchers are beginning to suggest that adults should take far more vitamin D than the 600 IU daily guideline. But too much may be dangerous. Very high doses of vitamin D can raise your blood calcium level, causing damage to blood vessels, heart, and kidneys. The Institute of Medicine sets the upper tolerable limit at 4,000 IU of vitamin D per day. Check with your health care provider for the right amount for you.

And what about additional vitamin D from the sun? Fortunately, you can’t get too much vitamin D from the sun because your body simply stops making more. But don’t forget that sun exposure without plenty of sunscreen can raise your risk of skin cancer. So, apply the sunscreen and take whatever supplement your provider recommends.

You thought when you got that pregnancy acne under control that you were good to go. And the overall itchiness of your stretching skin has been managed mostly by slathering on moisturizer every chance you get. So now what’s up with these reddish raised patches – poison ivy?!  It might be PUPPP.
 
No, that’s not a cute little puppy dog, which probably would be ever so much nicer.  PUPPP stands for pruritic urticarial papules and plaques of pregnancy (sounds and is rather nasty) which are series of small, very itchy bumps that can show up on your skin during the third trimester. They usually appear on the belly, especially if you have stretch marks, but some women have them on their thighs, rear end, breasts and upper arms - again wherever there are stretch marks.  The good news is they go away after delivery and just because you got them in one pregnancy does not mean you’ll have them in another. Actually, PUPPP appears to be most common in first pregnancies.

Also good to know is that, while we don’t know what causes it, PUPPP is not associated with serious issues like preeclampsia, autoimmune disorders or problems with the developing baby. It’s just a nasty rash that’s likely to irritate the daylights out of you.

Any rash should be shown to your health care provider.  She will treat the symptoms. High strength steroidal creams used 5 or 6 times a day usually are good to start with because they bring it under control and prevent spreading. Once under control, a lower strength cream is commonly prescribed. Oral antihistamines like Benadryl or Zyrtec may be helpful with relieving itching at night and helping you sleep, but don’t take these without first checking with your doc. For severe cases, oral steroids taken daily may be necessary. If you’re not keen on these options, try oatmeal baths or pine tar soap.

If you had PUPPP, what worked to control the itch for you?

Photo courtesy of Logical Images, Inc.

The perineum is the area between your vagina and rectum. It stretches during labor and vaginal birth, but sometimes it can’t stretch enough and it may tear. Tearing is common in childbirth, especially if you are delivering a baby over 8 ½ pounds or if forceps are used to help deliver him. If your baby is being delivered face up, there is more of a chance of tearing. You may be more likely to tear if this is your first labor and birth, or if you had tearing or an episiotomy (a cut made at the opening of the vagina to help widen the passage) in a previous birth.

Tearing may affect only the tissue around the vagina which should heal on its own, or the muscles between the vagina and anus may be torn which would require stitches by your provider post delivery. In more rare and severe cases, rectal tissue may be torn requiring the surgical skill of a specialist.

The perineum often is pretty sore after giving birth and it can take a couple of weeks before you’re comfortable enough to sit on a hard chair again. This is especially true if you have stitches from a tear or an episiotomy.  While healing, it is important to keep the area clean. Rinse with warm water after every time you use the toilet and always wipe from front to back to help prevent infection.

Here are some things you can do to help you feel more comfortable and heal sooner:
• Kegel exercises – These strengthen the muscles in the pelvic area, which helps the perineum heal. They’re easy to do – just squeeze the muscles you use to stop yourself from peeing. Hold the muscles tight for ten seconds, then release. You can do this anytime, anywhere (in the car, at the grocery store, in an elevator…) so do them whenever you think about it.
• Put a cold pack on your perineum – just be sure to wrap it in a towel so you don’t freeze any skin!
• Sit on a pillow. Some gals highly recommend a donut shaped pillow.
• Soak in a warm bath.
• Use stool softeners to keep from getting constipated.

If you try all this and you’re still really uncomfortable, ask your health care provider about pain medication for a few days. You can read more and watch a video about postpartum discomforts at this link.

Are you taking your children to a parade this weekend? They love to watch the folks who march and to listen to the bands playing. It’s important, though, to remember why we adults have the day off from work and why our children have no school.  It’s important to teach our children to be grateful for the freedoms we enjoy.

Thank you to all the many men and women and their families who have given so much to keep our country safe and secure.

Did the warm weather and sunshine last weekend boost you into overdrive like it did me? I was outside weeding, pruning shrubs that have already bloomed and planting some flowers. I dragged out the fertilizer for some things and went in search of weed killer for others.  I discovered a healthy crop of poison ivy and wanted to nip it in the bud before it really takes over that part of the garden.

We don’t have a garage, so we keep our chemicals on the top shelf of a “gardening room” in our basement where visiting children won’t see it. While mixing up and spreading all of these chemicals, it occurred to me that I was lucky I didn’t have small fry around at the time. It reminded me to mention once more how important it is to lock up poisons when not in use and to keep kids away from treated areas until it’s safe for them to be romping through the grass again. This goes for your pets, too.

Whenever you can, use non-chemical pesticides. But remember, even natural ingredients can sometimes be poisonous. Always read the label and follow instructions, including those for keeping them out of the hands of children and safely disposing of the empty containers.

If you’re going to be out in the yard this holiday weekend, wait to treat the weeds until the weekend’s over and yard traffic dies down. You’ll be able to relax and let the tots crawl in the grass without concern.

Stress incontinence is accidentally losing urine during physical activity, such as coughing, sneezing, laughing, or exercise. This major “Oops!” happens to a lot of us. One of the most common reasons for a woman to have this embarrassing lack of control is childbirth. Childbirth can weaken the pelvic muscles that support the bladder and urethra. It often is diagnosed in women who have had more than one pregnancy and vaginal delivery or who have pelvic prolapse. 

Women who develop stress incontinence during pregnancy are more likely to suffer from it afterward, as are obese women or women who smoke. It usually goes away after a few weeks or months post-delivery, but not for some of us lucky gals.

There are four types of treatment for stress incontinence: behavior changes; medication; pelvic floor muscle training; and surgery.  Obviously, taking the least drastic measure that proves successful is the better route to go.

Something that can be very helpful in tightening up that region again is continuing the kegel exercises you learned when you were pregnant, and doing them often. Shed those extra pounds that may be hanging on. Don’t give up drinking water or you might end up with a UTI. (Make sure you drink those 6-8 glasses a day.) Avoid alcohol and caffeine which can irritate your bladder.
 
If this is bothering you (and believe me it bothers lots of women), talk with your provider about help that’s best for you. You can read more about stress incontinence and treatment options at this link.

Are you taking the kids to visit Grandma and Grandpa this summer? Are you going on a vacation that requires air travel? As the summer travel season begins, the Federal Aviation Administration (FAA) has launched an education effort to help parents and caregivers make informed choices about their child’s safety when they fly. 

The FAA has developed a new web site and online toolkit with information about how to keep children safe when traveling by air.  The site includes a downloadable tip sheet for parents and caregivers and a video demonstration on how to properly install a child safety seat on an airplane.  Details about FAA-approved child harness devices and links to frequently asked questions also are included on the web site.  Click on this link for more information.    Check out the new web site at http://www.faa.gov/passengers/fly_children/.

Pregnancy is usually a wonderful time in a woman’s life. But, unfortunately, there are certain changes that many women experience that are bothersome or even painful. Constipation is a fairly common complaint during pregnancy. Constipation is when you have difficulty having a bowel movement, or do not have one for several days. It can be due to your diet, changing hormones, too much iron in a vitamin pill, or from the pressure of your baby. Whatever the cause, it is not fun.

Here are some tips that may help with constipation:

• Drink more water.
• Avoid caffeine.
• Choose plenty of fiber-rich foods, including fruits, raw veggies, beans and whole grains.
• Juices, such as prune juice, can help, too.
• Move more and sit less. Regular activity, such as walking, can help a lot.
• Ask your prenatal health care provider if you can switch to a different prenatal vitamin (perhaps one with low or no iron).

Pregnant women who suffer from constipation often have hemorrhoids, too. These are painful and itchy enlarged veins in the rectal area. Constipation can make these swollen, itchy veins worse. Talk to your doctor about using creams and suppositories to provide relief. But, do not take laxatives or mineral oil unless our doctor prescribes them. The tips to relieve constipation (above) will also help with hemorhoids. You can read more about this uncomfortable aspect of pregnancy on our website.

To learn more about healthy eating during pregnancy,visit our website.

Hopefully, with a little more attention to your diet and lifestyle, you will feel much better.

The U.S. Consumer Product Safety Commission (CPSC) and five retailers are announcing a voluntary recall to provide refunds to consumers who own crib tents and play yard tents made by Tots in Mind, Inc. The crib tents and play yard tents can present an entrapment and strangulation hazard to infants and toddlers if the dome portion inverts inside the crib or play yard, or if the product becomes partially detached from the crib or play yard.

CPSC staff urges parents and caregivers to stop using these crib tents and play yard tents immediately. Do not attempt to repair these products. CPSC is aware of 27 tent failures including one fatality and one serious injury that occurred between January 1997 and April 2012 from crib tents and play yard tents made by Tots in Mind, Inc.

Since Tots in Mind, Inc. is no longer in business, retailers who sold these products have stepped up to offer refunds or store credit to consumers. The recalled products were sold at numerous retail stores including Bed Bath & Beyond/Buy Buy Baby, Burlington Coat Factory, Toys R Us/Babies R Us, Walmart and online on websites including Amazon.com, for between $60 and $85.

Consumers should contact the store where the product was purchased to receive either a refund or store credit, depending on the retailer. Click on this link for more contact information.

More than 1,000 fewer babies died before celebrating their first birthday between 2007 and 2008, and many of them had the benefit of a full-term pregnancy, according to data just released by the National Center for Health Statistics.

The United States infant mortality rate declined 2 percent from 2007 to 2008. The rate dropped to 6.61 from 6.75 deaths for every 1,000 live births. The NCHS report found that all of this decrease in the infant mortality rate can be accounted for by a decrease in preterm births. While infant mortality rates were relatively unchanged between 2000 and 2005, this recent improvement represents a 4 percent decline in infant mortality since 2000 and a 13 percent decline since 1995.

“This data conclusively demonstrates that preventing premature birth saves lives,” said Dr. Jennifer L. Howse president of the March of Dimes. “But 28,000 babies still did not live to see their first birthday. No parent should ever have to experience the pain of losing a child from prematurity, or from any other cause.”

The U.S. preterm birth rate peaked in 2006 at 12.8 percent. It has dropped for four consecutive years to just less than 12 percent in 2010. Much of this improvement can be attributed to a decline in the rate of infants born just a few weeks early, which may be linked to better hospital practices that discourage elective early deliveries that can result in premature births.

The new NCHS statistics show that the earlier a baby is born, the greater the risk of death, but Dr. Howse says it’s important to note that even babies born just a few weeks early — between 34 and 36 weeks gestation — have a death rate three times as high as babies born at full term. In 2008, nearly two-thirds of all infant deaths occurred in the first month of life, and two-thirds of all infant deaths were preterm babies, according to the NCHS.

The March of Dimes has set a goal of lowering the national preterm birth rate to 9.6 percent of all births by 2020. This goal can be achieved by a combination of activities, including: giving all women of childbearing age access to healthcare coverage and preconception and prenatal care; fully implementing proven interventions to reduce the risk of an early birth, such as not smoking during pregnancy, progesterone treatments for women as appropriate, avoiding multiples from fertility treatments, avoiding elective inductions and Cesarean deliveries before 39 weeks of pregnancy unless medically necessary; and by funding new research into prevention of preterm birth.