The first time you hold your newborn in the delivery room, put his lips to your breast. Your mature milk hasn't come in yet, but your breasts are producing a substance called colostrum that will help protect your baby from infection.
Try not to panic if your newborn seems to have trouble finding or staying on your nipple. Breastfeeding is an art that requires patience and lots of practice. No one will expect you to be an expert in the beginning, so don't hesitate to ask a nurse to show you what to do while you're in the hospital. (If you have a premature baby, you may not be able to nurse right away, but you should start pumping your milk. Your baby will receive this milk through a tube or a bottle until he's strong enough to nurse.)
Once you get started, remember that nursing shouldn't be painful. Pay attention to how your breasts feel when your baby latches on. His mouth should cover a big part of the areola below the nipple, and your nipple should be far back in your baby's mouth. If latch-on hurts, break the suction — by inserting your little finger between your baby's gums and your nipple — and try again. Once your baby latches on properly, he'll do the rest.
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Saturday, February 27, 2010
Thursday, February 25, 2010
Ten maternity must-haves
Your climate and lifestyle will largely determine your maternity clothing needs, but the following pieces are essential. Thanks to companies like Belly Basics, you don't have to buy all of these items separately — instead you can pick up a "pregnancy survival kit" with several separates in one handy box.
1. A twin set: You feel warmer during pregnancy, so layering is key. Choose a sleeveless shell and long-sleeved cardigan so you can peel off a layer while looking pulled together and chic. You can also drape the cardigan over your shoulders for another look.
2. A wrap sweater: These tunic-length knit tops wrap around with an adjustable tie that you can fasten tighter early in pregnancy and looser as your belly grows. The soft lines and slim-fitting bodice create a flattering silhouette.
3. A classic T-shirt: From shorts to skirts, a classic tee goes with everything. Choose the style you prefer (i.e., crew or V-neck) but make sure there's a bit of stretch in the material so it'll grow with you.
4. A knit tunic top: While fitted across the shoulders and arms, a tunic provides plenty of room where women need it — across the middle, to accommodate growing bellies, and in the length, to cover expanding hips and bottoms.
5. Black stretch pants: They go with everything and can be worn from your first weeks of pregnancy through your postpartum months.
6. A slim-fitting skirt: These are more flattering than a full skirt. The length you choose will depend on your height: If you're shorter, opt for a knee-length hemline. If you're taller, experiment with a little more length — try a mid-calf line.
7. A men's-style button-down shirt: Borrow one of your husband's for a casual look, or choose a tailored maternity style (narrow through the top and shoulders with plenty of room for your growing belly) for a more polished feel.
8. A black dress: Just because you're pregnant doesn't mean this timeless and classic fashion staple is off-limits. It'll take you anywhere, from a dinner date with your mate to an evening out with friends.
9. Comfy undergarments: You'll need a couple of new bras to accommodate your larger-than-usual breasts. Don't be embarrassed to let a lingerie saleswoman help you get the proper fit. It's important that your breasts get the support they need and that you're comfortable. As for underwear, loose is key. If you wear briefs, you may prefer over-the-belly maternity underwear. Or buy your favorite thongs or bikinis a size or two larger and let the waistband rest under your tummy.
10. A few cool accessories: You can really punch up an outfit with a colorful scarf, chunky necklace, funky shoes, or hip handbag. An added bonus: If you splurge on accessories, at least you know you'll be able to wear them after the birth.
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1. A twin set: You feel warmer during pregnancy, so layering is key. Choose a sleeveless shell and long-sleeved cardigan so you can peel off a layer while looking pulled together and chic. You can also drape the cardigan over your shoulders for another look.
2. A wrap sweater: These tunic-length knit tops wrap around with an adjustable tie that you can fasten tighter early in pregnancy and looser as your belly grows. The soft lines and slim-fitting bodice create a flattering silhouette.
3. A classic T-shirt: From shorts to skirts, a classic tee goes with everything. Choose the style you prefer (i.e., crew or V-neck) but make sure there's a bit of stretch in the material so it'll grow with you.
4. A knit tunic top: While fitted across the shoulders and arms, a tunic provides plenty of room where women need it — across the middle, to accommodate growing bellies, and in the length, to cover expanding hips and bottoms.
5. Black stretch pants: They go with everything and can be worn from your first weeks of pregnancy through your postpartum months.
6. A slim-fitting skirt: These are more flattering than a full skirt. The length you choose will depend on your height: If you're shorter, opt for a knee-length hemline. If you're taller, experiment with a little more length — try a mid-calf line.
7. A men's-style button-down shirt: Borrow one of your husband's for a casual look, or choose a tailored maternity style (narrow through the top and shoulders with plenty of room for your growing belly) for a more polished feel.
8. A black dress: Just because you're pregnant doesn't mean this timeless and classic fashion staple is off-limits. It'll take you anywhere, from a dinner date with your mate to an evening out with friends.
9. Comfy undergarments: You'll need a couple of new bras to accommodate your larger-than-usual breasts. Don't be embarrassed to let a lingerie saleswoman help you get the proper fit. It's important that your breasts get the support they need and that you're comfortable. As for underwear, loose is key. If you wear briefs, you may prefer over-the-belly maternity underwear. Or buy your favorite thongs or bikinis a size or two larger and let the waistband rest under your tummy.
10. A few cool accessories: You can really punch up an outfit with a colorful scarf, chunky necklace, funky shoes, or hip handbag. An added bonus: If you splurge on accessories, at least you know you'll be able to wear them after the birth.
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Wednesday, February 24, 2010
Eleven reasons babies cry and how to soothe them
There's no getting around it: Babies cry. It's how they communicate hunger, pain, fear, a need for sleep, and more.
So how are parents supposed to know what their baby is trying to tell them? It can be tricky to interpret your child’s cries, especially at first.
Here are the most common reasons babies cry. If your little one is wailing and you don't know why, work your way down the list. Chances are you'll find something that helps.
1. Hunger
This is probably the first thing you think of when your baby cries.
Learning to recognize the signs of hunger will help you start your baby's feedings before the crying stage. Some signs to watch for in newborns: fussing, smacking of lips, rooting (a newborn reflex that causes babies to turn their head toward your hand when you stroke their cheek), and putting their hands to their mouth.
2. A dirty diaper
Some babies let you know right away when they need to be changed. Others can tolerate a dirty diaper for quite a while.
Either way, this one is easy to check and simple to remedy.
3. Needs sleep
Aren't babies lucky? When they're tired they can simply go to sleep – anytime, anywhere. Or so adults like to think.
In reality, it's harder for them than you might think. Instead of nodding off, babies may fuss and cry, especially if they're overly tired.
4. Wants to be held
Babies need a lot of cuddling. They like to see their parents' faces, hear their voices, and listen to their heartbeats, and can even detect their unique smell. Crying can be their way of asking to be held close.
You may wonder if you'll spoil your baby by holding him so much, but during the first few months of life that isn't possible. To give your arms some relief, try wearing your baby in a front carrier or sling.
5. Tummy troubles (gas, colic, and more)
Tummy troubles associated with gas or colic can lead to lots of crying. In fact, the rather mysterious condition called colic is defined as inconsolable crying for at least three hours a day, at least three days a week, at least three weeks in a row.
If your baby often fusses and cries right after being fed, he may be feeling some sort of tummy pain. Many parents swear by over-the-counter anti-gas drops for babies or gripe water (made from herbs and sodium bicarbonate). Get your doctor's okay before using either of these.
For more help, discover more than 20 strategies for soothing a colicky baby.
Even if your baby isn't colicky and has never been fussy after eating, an occasional bout of gas pain can make him miserable until he works it out. If you suspect gas, try something simple to eliminate it such as putting him on his back, holding his feet, and moving his legs in a gentle bicycling motion.
6. Needs to burp
Burping isn't mandatory. But if your baby cries after a feeding, a good burp may be all he needs.
Babies swallow air when they breastfeed or suck from a bottle, and if the air isn't released it may cause some discomfort. Some babies are intensely bothered by having air in their tummy, while others don't seem to burp or need to be burped much at all.
7. Too cold or too hot
When your baby feels chilly, such as when you remove his clothes to change a diaper or clean his bottom with a cold wipe, he may protest by crying.
Newborns like to be bundled up and kept warm — but not too warm. As a rule, they’re comfortable wearing one more layer than you need to be comfortable. Babies are less likely to complain about being too warm than about being too cold, and they won't cry about it as vigorously.
8. Something small
Babies can be troubled by something as hard to spot as a hair wrapped tightly around a tiny toe or finger, cutting off circulation. (Doctors call this painful situation a "hair tourniquet," and it's one of the first things they look for if a baby seems to be crying for no reason.) And some babies are extra sensitive to things like scratchy clothing tags or fabric.
9. Teething
Teething can be painful as each new tooth pushes through tender young gums. Some babies suffer more than others, but all are likely to be fussy and tearful at some point along the way.
If your baby seems to be in pain and you're not sure why, try feeling his gums with your finger. You may be surprised to discover the hard nub of a baby tooth on its way in.
On average, the first tooth breaks through between 4 and 7 months, but it can happen earlier. Find out more about teething and how to ease the pain.
10. Feeling overwhelmed
Babies learn from the stimulation of the world around them, but sometimes they have a hard time processing it all — the lights, the noise, being passed from hand to hand. Crying can be his his way of saying, "I've had enough."
If your baby's having a meltdown, try retreating to a serene spot and letting him vent for a while.
11. Not feeling well
If you've met your baby's basic needs and comforted him and he's still crying, he could be coming down with something. You may want to check his temperature to rule out a fever and be alert for other signs of illness.
The cry of a sick baby tends to be distinct from one caused by hunger or frustration. If your baby's crying "just doesn't sound right," trust your instincts and call or see a doctor.
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So how are parents supposed to know what their baby is trying to tell them? It can be tricky to interpret your child’s cries, especially at first.
Here are the most common reasons babies cry. If your little one is wailing and you don't know why, work your way down the list. Chances are you'll find something that helps.
1. Hunger
This is probably the first thing you think of when your baby cries.
Learning to recognize the signs of hunger will help you start your baby's feedings before the crying stage. Some signs to watch for in newborns: fussing, smacking of lips, rooting (a newborn reflex that causes babies to turn their head toward your hand when you stroke their cheek), and putting their hands to their mouth.
2. A dirty diaper
Some babies let you know right away when they need to be changed. Others can tolerate a dirty diaper for quite a while.
Either way, this one is easy to check and simple to remedy.
3. Needs sleep
Aren't babies lucky? When they're tired they can simply go to sleep – anytime, anywhere. Or so adults like to think.
In reality, it's harder for them than you might think. Instead of nodding off, babies may fuss and cry, especially if they're overly tired.
4. Wants to be held
Babies need a lot of cuddling. They like to see their parents' faces, hear their voices, and listen to their heartbeats, and can even detect their unique smell. Crying can be their way of asking to be held close.
You may wonder if you'll spoil your baby by holding him so much, but during the first few months of life that isn't possible. To give your arms some relief, try wearing your baby in a front carrier or sling.
5. Tummy troubles (gas, colic, and more)
Tummy troubles associated with gas or colic can lead to lots of crying. In fact, the rather mysterious condition called colic is defined as inconsolable crying for at least three hours a day, at least three days a week, at least three weeks in a row.
If your baby often fusses and cries right after being fed, he may be feeling some sort of tummy pain. Many parents swear by over-the-counter anti-gas drops for babies or gripe water (made from herbs and sodium bicarbonate). Get your doctor's okay before using either of these.
For more help, discover more than 20 strategies for soothing a colicky baby.
Even if your baby isn't colicky and has never been fussy after eating, an occasional bout of gas pain can make him miserable until he works it out. If you suspect gas, try something simple to eliminate it such as putting him on his back, holding his feet, and moving his legs in a gentle bicycling motion.
6. Needs to burp
Burping isn't mandatory. But if your baby cries after a feeding, a good burp may be all he needs.
Babies swallow air when they breastfeed or suck from a bottle, and if the air isn't released it may cause some discomfort. Some babies are intensely bothered by having air in their tummy, while others don't seem to burp or need to be burped much at all.
7. Too cold or too hot
When your baby feels chilly, such as when you remove his clothes to change a diaper or clean his bottom with a cold wipe, he may protest by crying.
Newborns like to be bundled up and kept warm — but not too warm. As a rule, they’re comfortable wearing one more layer than you need to be comfortable. Babies are less likely to complain about being too warm than about being too cold, and they won't cry about it as vigorously.
8. Something small
Babies can be troubled by something as hard to spot as a hair wrapped tightly around a tiny toe or finger, cutting off circulation. (Doctors call this painful situation a "hair tourniquet," and it's one of the first things they look for if a baby seems to be crying for no reason.) And some babies are extra sensitive to things like scratchy clothing tags or fabric.
9. Teething
Teething can be painful as each new tooth pushes through tender young gums. Some babies suffer more than others, but all are likely to be fussy and tearful at some point along the way.
If your baby seems to be in pain and you're not sure why, try feeling his gums with your finger. You may be surprised to discover the hard nub of a baby tooth on its way in.
On average, the first tooth breaks through between 4 and 7 months, but it can happen earlier. Find out more about teething and how to ease the pain.
10. Feeling overwhelmed
Babies learn from the stimulation of the world around them, but sometimes they have a hard time processing it all — the lights, the noise, being passed from hand to hand. Crying can be his his way of saying, "I've had enough."
If your baby's having a meltdown, try retreating to a serene spot and letting him vent for a while.
11. Not feeling well
If you've met your baby's basic needs and comforted him and he's still crying, he could be coming down with something. You may want to check his temperature to rule out a fever and be alert for other signs of illness.
The cry of a sick baby tends to be distinct from one caused by hunger or frustration. If your baby's crying "just doesn't sound right," trust your instincts and call or see a doctor.
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Monday, February 22, 2010
How much weight will I lose right after giving birth?
You probably won't return to your pre-pregnancy weight for some time, but you will lose a significant amount of weight immediately after delivery. Subtracting one 7- to 8-pound baby, another pound or two of placenta, and another 2 pounds or so of blood and amniotic fluid leaves most new moms about 12 pounds lighter.
The weight keeps coming off, too. All the extra water that your cells retained during pregnancy, along with fluid from the extra blood you had in your pregnant body, will be looking for a way out.
So you'll produce more urine than usual in the days after birth — an astounding 3 quarts a day. And you may perspire a lot, too. By the end of the first week, you'll lose about 4 pounds of water weight. (The amount varies depending on how much water you retained during pregnancy.)
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How long will it take for my uterus to shrink?
By the time you go into labor, your uterus is about 15 times heavier (not including its contents!) and its capacity is at least 500 times greater than before you conceived. Within minutes after your baby is born, contractions cause your uterus to shrink, clenching itself like a fist, its crisscrossed fibers tightening in the same way they do during labor.
These contractions cause the placenta to separate from the uterine wall. After the placenta is delivered, the uterus clamps down even more, closing off open blood vessels in the area where the placenta was attached. As the uterus continues to contract, you may feel cramps known as afterpains.
For the first couple of days after birth, you can feel the top of your uterus at or a few finger widths below the level of your belly button. In a week your uterus weighs about a pound - half of what it weighed at delivery. After two weeks it's down to a mere 11 ounces and located entirely within your pelvis. By four to six weeks, it should be close to its pre-pregnancy weight of about 2.5 ounces. This process is called involution of the uterus.
Even after your uterus shrinks back into your pelvis, you may continue to look somewhat pregnant for several weeks or longer. That's because your abdominal muscles get stretched out during pregnancy, and it will take time – and regular exercise – to get your belly back in shape.
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Sunday, February 21, 2010
Milk for Mom May Lower Baby’s MS Risk
Feb. 9, 2010 -- Pregnant women who drink plenty of milk may be protecting their child from developing multiple sclerosis (MS) in the future.
MS is a nervous system disease that attacks the material, called myelin, that covers nerve fibers. This disrupts signaling between nerves and causes nerve damage, leading to symptoms such as numbness, tingling, fatigue, loss of vision, and possibly, paralysis. The disease most often strikes adults after age 20, but it can develop in children.
Growing evidence has suggested that vitamin D, found in fortified milk, may lower one’s risk of MS. Now, researchers with the Harvard School of Public Health in Boston have shown that it’s possible this protective benefit could begin while a baby is developing in the womb.
The study involved more than 35,000 female nurses whose mothers answered questions about their diet habits during pregnancy. It revealed that women born to mothers who had the highest intake of vitamin D had a much lower risk of developing MS as an adult. Among the nurses studied, 199 developed MS over the 16-year study period.
"The risk of MS among daughters whose mothers consumed four glasses of milk per day was 56% lower than daughters whose mothers consumed less than three glasses of milk per month," Harvard researcher Fariba Mirzaei, MD, says in a news release.
"We also found the risk of MS among daughters whose mothers were in the top 20% of vitamin D intake during pregnancy was 45% lower than daughters whose mothers were in the bottom 20% for vitamin D intake during pregnancy."
Vitamin D is found in certain foods and beverages such as fortified milk and cereals, and fatty fish such as salmon. However, few foods naturally contain the vitamin. Your body also makes vitamin D after the skin absorbs some of the sun’s rays. Sunlight is one of the most important sources of vitamin D.
Researchers will present their findings in April at the American Academy of Neurology's 62nd Annual Meeting in Toronto.
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MS is a nervous system disease that attacks the material, called myelin, that covers nerve fibers. This disrupts signaling between nerves and causes nerve damage, leading to symptoms such as numbness, tingling, fatigue, loss of vision, and possibly, paralysis. The disease most often strikes adults after age 20, but it can develop in children.
Growing evidence has suggested that vitamin D, found in fortified milk, may lower one’s risk of MS. Now, researchers with the Harvard School of Public Health in Boston have shown that it’s possible this protective benefit could begin while a baby is developing in the womb.
The study involved more than 35,000 female nurses whose mothers answered questions about their diet habits during pregnancy. It revealed that women born to mothers who had the highest intake of vitamin D had a much lower risk of developing MS as an adult. Among the nurses studied, 199 developed MS over the 16-year study period.
"The risk of MS among daughters whose mothers consumed four glasses of milk per day was 56% lower than daughters whose mothers consumed less than three glasses of milk per month," Harvard researcher Fariba Mirzaei, MD, says in a news release.
"We also found the risk of MS among daughters whose mothers were in the top 20% of vitamin D intake during pregnancy was 45% lower than daughters whose mothers were in the bottom 20% for vitamin D intake during pregnancy."
Vitamin D is found in certain foods and beverages such as fortified milk and cereals, and fatty fish such as salmon. However, few foods naturally contain the vitamin. Your body also makes vitamin D after the skin absorbs some of the sun’s rays. Sunlight is one of the most important sources of vitamin D.
Researchers will present their findings in April at the American Academy of Neurology's 62nd Annual Meeting in Toronto.
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Friday, February 19, 2010
Nutrition during the pregnancy
Firstly, if you’ve been following a healthy diet before you fell pregnant, chances are you won’t have to make any major changes to what you eat. However there are some particular nutritional requirements you should be aware of, as a well-balanced diet contributes to:
normal birth weight for baby
improved fetal brain development
decreased chance of pregnancy complications such as morning sickness, fatigue, mood swings, anaemia and pre-eclampsia
a speedy recovery after delivery
Eating for two
Yes, you are eating for two, but that does NOT mean increasing your kilojoule intake — particularly in the first trimester. Rather, it means you will need to increase your intake of certain nutrients — mainly folate, iron and calcium — to maintain optimal foetal development and your own health. In the second and third trimesters you may need to increase your kilojoule intake by around 10% (or around 6000 kJ per day); but generally a healthy pregnant woman should aim to keep her weight gain around 10-15kg during the course of the pregnancy.
Pregnancy is NOT a time to aim for weight loss or restricting your diet, unless under doctor’s advice for overweight mothers, and then only under strict medical supervision. Crash diets during pregnancy are a serious risk for both mother and developing baby.
What to eat
The basis of a well-balanced diet is a balance of grains, fruits and vegetables, protein, dairy and fats. Ensure your diet contains the recommended amounts of the following food groups.
Grain products are the main source of complex carbohydrates, and should make up the majority of your diet. Complex carbohydrates provide you with energy and will keep your weight gain in check, prevent constipation and nausea, and give your baby essential nutrients including fibre, folate, Vitamin B and protein.
Eat at least six servings per day, preferably wholegrains such as whole-wheat bread, cereals, brown rice or pasta. One serving is two slices of bread, or a cup of cooked rice or pasta. Avoid refined grain products such as white bread and white rice, biscuits and cakes etc as these don’t have the same nutritional value as their wholegrain counterparts.
Fruit and vegetables will provide you with essential vitamins and minerals as well as fibre to aid digestion and prevent constipation. Vitamin A derived from green leafy veges and yellow fruits is important for the development of your baby’s bones, skin, hair and eyes; however when taken in supplement format, Vitamin A has been linked to birth deformities so it's doubly important to source it from whole foods. Vitamin C is important for bone growth and tissue repair, however your body cannot store large amounts of it so it’s important to ensure a regular intake – around 3 serves per day. Good sources include citrus, tomatoes, broccoli, melons and berries. Fruit and veges also provide you with folate, Vitamin B, iron and calcium.
Eat at least five serves of vegetables and two serves of fruit each day. One serving is a cup of salad leaves or 1/2 cup chopped non-leafy vegetables or fruit (cooked or raw), one whole raw fruit, a small glass of juice or dried fruit (such as 4 dried apricots, or 1.5 tablespoons sultanas).
Protein is composed of amino acids, the building blocks of human cells which are crucial for a developing fetus. It is also important in protecting you against developing pre-eclampsia later in pregnancy. Protein foods are also normally the iron-rich foods, which is important to keep your blood well-oxygenated.
Eat at least two servings per day. One serving equals 100g lean meat, poultry or fish; two small eggs, 1/2 cup cooked lentils, split peas, or dried beans; 1/4 cup sunflower or sesame seeds; 2 cups low-fat yoghurt; 200g tofu; 1 cup low-fat cottage cheese. Nuts are a good source of protein but be careful not to eat too many peanuts during pregnancy to avoid your baby developing a nut allergy.
Dairy The calcium found in milk products helps build your baby's bones and teeth, as well as muscle, heart and nerve development and blood clotting. If your calcium intake isn’t sufficient to meet your baby’s needs, especially later in the pregnancy, your body will draw on calcium from your bones and therefore expose you to the risk of osteoporosis. Choose at least four servings a day of low-fat milk, yogurt or cheese. A serving is one cup of milk or yogurt or two slices of cheese. If you have trouble digesting lactose, lactose-reduced milk products and calcium-fortified juice can help you get enough calcium. Another good source is canned fish with bones (such as salmon or sardines).
Fat Some fats are necessary for your baby’s development, but you should limit your intake to manage weight gain during pregnancy. Treat yourself to an occasional sweet treat: icecream, chocolate biscuit or piece of cake, but don’t include them as a daily part of your diet. Essential fats are found in polyunsaturated oils such as sunflower and soya bean oils, and monounsaturated oils such as olive and canola oils.
Water and fluids: you need to drink at least two litres of water a day; and more if you’re retaining fluid or if it’s very hot. Your need for fluids will also increase as your body’s fluids increase in the course of the pregnancy. An adequate fluid intake will help in the prevention of early labour, stretch marks, and constipation.
While water is best, you can make up some of your intake with other fluids such as juice, milk, and soup. However, try to limit caffeine-containing beverages such as coffee, tea and colas to only one cup per day.
In an ideal world we’d all be eating according to the above guidelines before we fell pregnant, if not from day one of the pregnancy. But changing from bad eating habits to good takes dedication and hard work, so if you find it difficult to follow this diet, make changes gradually. Don’t expect yourself to stick to it if you’re facing it alone: encourage your partner and family to improve their diet too.
You’ll also find it easier to eat well if you give yourself an occasional treat – so don’t beat yourself up if you indulge in a late-night hot chocolate before bed or something sweet with your morning cuppa. Wherever you can, try to make it a healthy alternative though: a slice of banana bread vs a chocolate éclair, or a fresh strawberry smoothie instead of a vanilla milkshake.
And remember that every day you improve your diet means not only a healthier baby, but long-term health effects for you, too.
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normal birth weight for baby
improved fetal brain development
decreased chance of pregnancy complications such as morning sickness, fatigue, mood swings, anaemia and pre-eclampsia
a speedy recovery after delivery
Eating for two
Yes, you are eating for two, but that does NOT mean increasing your kilojoule intake — particularly in the first trimester. Rather, it means you will need to increase your intake of certain nutrients — mainly folate, iron and calcium — to maintain optimal foetal development and your own health. In the second and third trimesters you may need to increase your kilojoule intake by around 10% (or around 6000 kJ per day); but generally a healthy pregnant woman should aim to keep her weight gain around 10-15kg during the course of the pregnancy.
Pregnancy is NOT a time to aim for weight loss or restricting your diet, unless under doctor’s advice for overweight mothers, and then only under strict medical supervision. Crash diets during pregnancy are a serious risk for both mother and developing baby.
What to eat
The basis of a well-balanced diet is a balance of grains, fruits and vegetables, protein, dairy and fats. Ensure your diet contains the recommended amounts of the following food groups.
Grain products are the main source of complex carbohydrates, and should make up the majority of your diet. Complex carbohydrates provide you with energy and will keep your weight gain in check, prevent constipation and nausea, and give your baby essential nutrients including fibre, folate, Vitamin B and protein.
Eat at least six servings per day, preferably wholegrains such as whole-wheat bread, cereals, brown rice or pasta. One serving is two slices of bread, or a cup of cooked rice or pasta. Avoid refined grain products such as white bread and white rice, biscuits and cakes etc as these don’t have the same nutritional value as their wholegrain counterparts.
Fruit and vegetables will provide you with essential vitamins and minerals as well as fibre to aid digestion and prevent constipation. Vitamin A derived from green leafy veges and yellow fruits is important for the development of your baby’s bones, skin, hair and eyes; however when taken in supplement format, Vitamin A has been linked to birth deformities so it's doubly important to source it from whole foods. Vitamin C is important for bone growth and tissue repair, however your body cannot store large amounts of it so it’s important to ensure a regular intake – around 3 serves per day. Good sources include citrus, tomatoes, broccoli, melons and berries. Fruit and veges also provide you with folate, Vitamin B, iron and calcium.
Eat at least five serves of vegetables and two serves of fruit each day. One serving is a cup of salad leaves or 1/2 cup chopped non-leafy vegetables or fruit (cooked or raw), one whole raw fruit, a small glass of juice or dried fruit (such as 4 dried apricots, or 1.5 tablespoons sultanas).
Protein is composed of amino acids, the building blocks of human cells which are crucial for a developing fetus. It is also important in protecting you against developing pre-eclampsia later in pregnancy. Protein foods are also normally the iron-rich foods, which is important to keep your blood well-oxygenated.
Eat at least two servings per day. One serving equals 100g lean meat, poultry or fish; two small eggs, 1/2 cup cooked lentils, split peas, or dried beans; 1/4 cup sunflower or sesame seeds; 2 cups low-fat yoghurt; 200g tofu; 1 cup low-fat cottage cheese. Nuts are a good source of protein but be careful not to eat too many peanuts during pregnancy to avoid your baby developing a nut allergy.
Dairy The calcium found in milk products helps build your baby's bones and teeth, as well as muscle, heart and nerve development and blood clotting. If your calcium intake isn’t sufficient to meet your baby’s needs, especially later in the pregnancy, your body will draw on calcium from your bones and therefore expose you to the risk of osteoporosis. Choose at least four servings a day of low-fat milk, yogurt or cheese. A serving is one cup of milk or yogurt or two slices of cheese. If you have trouble digesting lactose, lactose-reduced milk products and calcium-fortified juice can help you get enough calcium. Another good source is canned fish with bones (such as salmon or sardines).
Fat Some fats are necessary for your baby’s development, but you should limit your intake to manage weight gain during pregnancy. Treat yourself to an occasional sweet treat: icecream, chocolate biscuit or piece of cake, but don’t include them as a daily part of your diet. Essential fats are found in polyunsaturated oils such as sunflower and soya bean oils, and monounsaturated oils such as olive and canola oils.
Water and fluids: you need to drink at least two litres of water a day; and more if you’re retaining fluid or if it’s very hot. Your need for fluids will also increase as your body’s fluids increase in the course of the pregnancy. An adequate fluid intake will help in the prevention of early labour, stretch marks, and constipation.
While water is best, you can make up some of your intake with other fluids such as juice, milk, and soup. However, try to limit caffeine-containing beverages such as coffee, tea and colas to only one cup per day.
In an ideal world we’d all be eating according to the above guidelines before we fell pregnant, if not from day one of the pregnancy. But changing from bad eating habits to good takes dedication and hard work, so if you find it difficult to follow this diet, make changes gradually. Don’t expect yourself to stick to it if you’re facing it alone: encourage your partner and family to improve their diet too.
You’ll also find it easier to eat well if you give yourself an occasional treat – so don’t beat yourself up if you indulge in a late-night hot chocolate before bed or something sweet with your morning cuppa. Wherever you can, try to make it a healthy alternative though: a slice of banana bread vs a chocolate éclair, or a fresh strawberry smoothie instead of a vanilla milkshake.
And remember that every day you improve your diet means not only a healthier baby, but long-term health effects for you, too.
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Wednesday, February 17, 2010
Breast Feeding -8
Exclusive breastfeeding
Two 25ml samples of human breast milk. The left hand sample is foremilk, the watery milk coming from a full breast. The right hand sample is hindmilk, the creamy milk coming from a nearly empty breast.[77]Exclusive breastfeeding is defined as "an infant's consumption of human milk with no supplementation of any type (no water, no juice, no nonhuman milk, and no foods) except for vitamins, minerals, and medications."[8] National and international guidelines recommend that all infants be breastfed exclusively for the first six months of life. Breastfeeding may continue with the addition of appropriate foods, for two years or more. Exclusive breastfeeding has dramatically reduced infant deaths in developing countries by reducing diarrhea and infectious diseases. It has also been shown to reduce HIV transmission from mother to child, compared to mixed feeding.
Exclusively breastfed infants feed anywhere from 6 to 14 times a day. Newborns consume from 30 to 90 ml (1 to 3 US fluid ounces) per feed. After the age of four weeks, babies consume about 120ml (4 US fluid ounces) per feed. Each baby is different, but as it grows the amount will increase. It is important to recognize the baby's hunger signs. It is assumed that the baby knows how much milk it needs and it is therefore advised that the baby should dictate the number, frequency, and length of each feed. The supply of milk from the breast is determined by the number and length of these feeds or the amount of milk expressed. The birth weight of the baby may affect its feeding habits, and mothers may be influenced by what they perceive its requirements to be. For example, a baby born small for gestational age may lead a mother to believe that her child needs to feed more than if it larger; they should, however, go by the demands of the baby rather than what they feel is necessary.
While it can be hard to measure how much food a breastfed baby consumes, babies normally feed to meet their own requirements. Babies that fail to eat enough may exhibit symptoms of failure to thrive. If necessary, it is possible to estimate feeding from wet and soiled nappies (diapers): 8 wet cloth or 5–6 wet disposable, and 2–5 soiled per 24 hours suggests an acceptable amount of input for newborns older than 5–6 days old. After 2–3 months, stool frequency is a less accurate measure of adequate input as some normal infants may go up to 10 days between stools. Babies can also be weighed before and after feeds.
Expressing breast milk
Manual breast pumpWhen direct breastfeeding is not possible, a mother can express (artificially remove and store) her milk. With manual massage or using a breast pump, a woman can express her milk and keep it in freezer storage bags, a supplemental nursing system, or a bottle ready for use. Breast milk may be kept at room temperature for up to ten hours, refrigerated for up to eight days or frozen for up to four to six months. Research suggests that the antioxidant activity in expressed breast milk decreases over time but it still remains at higher levels than in infant formula.
Expressing breast milk can maintain a mother's milk supply when she and her child are apart. If a sick baby is unable to feed, expressed milk can be fed through a nasogastric tube.
Expressed milk can also be used when a mother is having trouble breastfeeding, such as when a newborn causes grazing and bruising. If an older baby bites the nipple, the mother's reaction - a jump and a cry of pain - is usually enough to discourage the child from biting again.
"Exclusively expressing", "exclusively pumping" and "EPing" are terms for a mother who feeds her baby exclusively on her breastmilk while not physically breastfeeding. This may arise because her baby is unable or unwilling to latch on to the breast. With good pumping habits, particularly in the first 12 weeks when the milk supply is being established, it is possible to produce enough milk to feed the baby for as long as the mother wishes. Kellymom has a page of links relating to exclusive pumping.
It is generally advised to delay using a bottle to feed expressed breast milk until the baby is 4–6 weeks old and is good at sucking directly from the breast. As sucking from a bottle takes less effort, babies can lose their desire to suck from the breast. This is called nursing strike or nipple confusion. To avoid this when feeding expressed breast milk (EBM) before 4–6 weeks of age, it is recommended that breast milk be given by other means such as feeding spoons or feeding cups. Also, EBM should be given by someone other than the breastfeeding mother (or wet nurse), so that the baby can learn to associate direct feeding with the mother (or wet nurse) and associate bottle feeding with other people.[citation needed]
Some women donate their expressed breast milk (EBM) to others, either directly or through a milk bank. Though historically the use of wet nurses was common, some women dislike the idea of feeding their own child with another woman's milk; others appreciate being able to give their baby the benefits of breast milk. Feeding expressed breast milk—either from donors or the baby's own mother—is the feeding method of choice for premature babies. The transmission of some viral diseases through breastfeeding can be prevented by expressing breast milk and subjecting it to Holder pasteurisation.
Mixed feeding
Expressed breast milk (EBM) or infant formula can be fed to an infant by bottlePredominant or mixed breastfeeding means feeding breast milk along with infant formula, baby food and even water, depending on the age of the child. Babies feed differently with artificial teats than from a breast. With the breast, the infant's tongue massages the milk out rather than sucking, and the nipple does not go as far into the mouth; with an artificial teat, an infant will suck harder and the milk may come in more rapidly. Therefore, mixing breastfeeding and bottle-feeding (or using a pacifier) before the baby is used to feeding from its mother can result in the infant preferring the bottle to the breast. Orthodontic teats, which are generally slightly longer, are closer to the nipple. Some mothers supplement feed with a small syringe or flexible cup to reduce the risk of artificial nipple preference.
Tandem breastfeeding
Feeding two children at the same time is called tandem breastfeeding The most common reason for tandem breastfeeding is the birth of twins, although women with closely spaced children can and do continue to nurse the older as well as the younger. As the appetite and feeding habits of each baby may not be the same, this could mean feeding each according to their own individual needs, and can also include breastfeeding them together, one on each breast.
In cases of triplets or more, it is a challenge for a mother to organize feeding around the appetites of all the babies. While breasts can respond to the demand and produce large quantities of milk, it is common for women to use alternatives. However, some mothers have been able to breastfeed triplets successfully.
Tandem breastfeeding may also occur when a woman has a baby while breastfeeding an older child. During the late stages of pregnancy the milk will change to colostrum, and some older nurslings will continue to feed even with this change, while others may wean due to the change in taste or drop in supply. Feeding a child while being pregnant with another can also be considered a form of tandem feeding for the nursing mother, as she also provides the nutrition for two.
Extended breastfeeding
Breastfeeding past two years is called "full term breastfeeding" or extended breastfeeding or "sustained breastfeeding" by supporters and those outside the U.S. Supporters of extended breastfeeding believe that all the benefits of human milk, nutritional, immunological and emotional, continue for as long as a child nurses. Often the older child will nurse infrequently or sporadically as a way of bonding with the mother.[citation needed]
Shared breastfeeding
Main article: Wet nurse
It used to be common worldwide, and still is in developing nations such as those in Africa, for more than one woman to breastfeed a child. Shared breastfeeding is a risk factor for HIV infection in infants. A woman who is engaged to breastfeed another's baby is known as a wet nurse. Islam has codified the relationship between this woman and the infants she nurses, and also between the infants when they grow up, so that milk siblings are considered as blood siblings and cannot marry (mahram). Shared breastfeeding can incur strong negative reactions in the Anglosphere; American feminist activist Jennifer Baumgardner has written about her experiences in New York with this issue.
Weaning
Weaning is the process of introducing the infant to other food and reducing the supply of breast milk. The infant is fully weaned when it no longer receives any breast milk. Most mammals stop producing the enzyme lactase at the end of weaning, and become lactose intolerant. Humans often have a mutation, with frequency depending primarily on ethnic background, that allows the production of lactase throughout life and so can drink milk - usually cow or goat milk - well beyond infancy.
In the past, bromocriptine was sometimes used to reduce the engorgement experienced by many women during weaning. However, it was discovered that when used for this purpose, this medication posed serious health risks to women such as stroke and seizures, and the U.S. Food and Drug Administration withdrew this indication for the drug in 1994.
Two 25ml samples of human breast milk. The left hand sample is foremilk, the watery milk coming from a full breast. The right hand sample is hindmilk, the creamy milk coming from a nearly empty breast.[77]Exclusive breastfeeding is defined as "an infant's consumption of human milk with no supplementation of any type (no water, no juice, no nonhuman milk, and no foods) except for vitamins, minerals, and medications."[8] National and international guidelines recommend that all infants be breastfed exclusively for the first six months of life. Breastfeeding may continue with the addition of appropriate foods, for two years or more. Exclusive breastfeeding has dramatically reduced infant deaths in developing countries by reducing diarrhea and infectious diseases. It has also been shown to reduce HIV transmission from mother to child, compared to mixed feeding.
Exclusively breastfed infants feed anywhere from 6 to 14 times a day. Newborns consume from 30 to 90 ml (1 to 3 US fluid ounces) per feed. After the age of four weeks, babies consume about 120ml (4 US fluid ounces) per feed. Each baby is different, but as it grows the amount will increase. It is important to recognize the baby's hunger signs. It is assumed that the baby knows how much milk it needs and it is therefore advised that the baby should dictate the number, frequency, and length of each feed. The supply of milk from the breast is determined by the number and length of these feeds or the amount of milk expressed. The birth weight of the baby may affect its feeding habits, and mothers may be influenced by what they perceive its requirements to be. For example, a baby born small for gestational age may lead a mother to believe that her child needs to feed more than if it larger; they should, however, go by the demands of the baby rather than what they feel is necessary.
While it can be hard to measure how much food a breastfed baby consumes, babies normally feed to meet their own requirements. Babies that fail to eat enough may exhibit symptoms of failure to thrive. If necessary, it is possible to estimate feeding from wet and soiled nappies (diapers): 8 wet cloth or 5–6 wet disposable, and 2–5 soiled per 24 hours suggests an acceptable amount of input for newborns older than 5–6 days old. After 2–3 months, stool frequency is a less accurate measure of adequate input as some normal infants may go up to 10 days between stools. Babies can also be weighed before and after feeds.
Expressing breast milk
Manual breast pumpWhen direct breastfeeding is not possible, a mother can express (artificially remove and store) her milk. With manual massage or using a breast pump, a woman can express her milk and keep it in freezer storage bags, a supplemental nursing system, or a bottle ready for use. Breast milk may be kept at room temperature for up to ten hours, refrigerated for up to eight days or frozen for up to four to six months. Research suggests that the antioxidant activity in expressed breast milk decreases over time but it still remains at higher levels than in infant formula.
Expressing breast milk can maintain a mother's milk supply when she and her child are apart. If a sick baby is unable to feed, expressed milk can be fed through a nasogastric tube.
Expressed milk can also be used when a mother is having trouble breastfeeding, such as when a newborn causes grazing and bruising. If an older baby bites the nipple, the mother's reaction - a jump and a cry of pain - is usually enough to discourage the child from biting again.
"Exclusively expressing", "exclusively pumping" and "EPing" are terms for a mother who feeds her baby exclusively on her breastmilk while not physically breastfeeding. This may arise because her baby is unable or unwilling to latch on to the breast. With good pumping habits, particularly in the first 12 weeks when the milk supply is being established, it is possible to produce enough milk to feed the baby for as long as the mother wishes. Kellymom has a page of links relating to exclusive pumping.
It is generally advised to delay using a bottle to feed expressed breast milk until the baby is 4–6 weeks old and is good at sucking directly from the breast. As sucking from a bottle takes less effort, babies can lose their desire to suck from the breast. This is called nursing strike or nipple confusion. To avoid this when feeding expressed breast milk (EBM) before 4–6 weeks of age, it is recommended that breast milk be given by other means such as feeding spoons or feeding cups. Also, EBM should be given by someone other than the breastfeeding mother (or wet nurse), so that the baby can learn to associate direct feeding with the mother (or wet nurse) and associate bottle feeding with other people.[citation needed]
Some women donate their expressed breast milk (EBM) to others, either directly or through a milk bank. Though historically the use of wet nurses was common, some women dislike the idea of feeding their own child with another woman's milk; others appreciate being able to give their baby the benefits of breast milk. Feeding expressed breast milk—either from donors or the baby's own mother—is the feeding method of choice for premature babies. The transmission of some viral diseases through breastfeeding can be prevented by expressing breast milk and subjecting it to Holder pasteurisation.
Mixed feeding
Expressed breast milk (EBM) or infant formula can be fed to an infant by bottlePredominant or mixed breastfeeding means feeding breast milk along with infant formula, baby food and even water, depending on the age of the child. Babies feed differently with artificial teats than from a breast. With the breast, the infant's tongue massages the milk out rather than sucking, and the nipple does not go as far into the mouth; with an artificial teat, an infant will suck harder and the milk may come in more rapidly. Therefore, mixing breastfeeding and bottle-feeding (or using a pacifier) before the baby is used to feeding from its mother can result in the infant preferring the bottle to the breast. Orthodontic teats, which are generally slightly longer, are closer to the nipple. Some mothers supplement feed with a small syringe or flexible cup to reduce the risk of artificial nipple preference.
Tandem breastfeeding
Feeding two children at the same time is called tandem breastfeeding The most common reason for tandem breastfeeding is the birth of twins, although women with closely spaced children can and do continue to nurse the older as well as the younger. As the appetite and feeding habits of each baby may not be the same, this could mean feeding each according to their own individual needs, and can also include breastfeeding them together, one on each breast.
In cases of triplets or more, it is a challenge for a mother to organize feeding around the appetites of all the babies. While breasts can respond to the demand and produce large quantities of milk, it is common for women to use alternatives. However, some mothers have been able to breastfeed triplets successfully.
Tandem breastfeeding may also occur when a woman has a baby while breastfeeding an older child. During the late stages of pregnancy the milk will change to colostrum, and some older nurslings will continue to feed even with this change, while others may wean due to the change in taste or drop in supply. Feeding a child while being pregnant with another can also be considered a form of tandem feeding for the nursing mother, as she also provides the nutrition for two.
Extended breastfeeding
Breastfeeding past two years is called "full term breastfeeding" or extended breastfeeding or "sustained breastfeeding" by supporters and those outside the U.S. Supporters of extended breastfeeding believe that all the benefits of human milk, nutritional, immunological and emotional, continue for as long as a child nurses. Often the older child will nurse infrequently or sporadically as a way of bonding with the mother.[citation needed]
Shared breastfeeding
Main article: Wet nurse
It used to be common worldwide, and still is in developing nations such as those in Africa, for more than one woman to breastfeed a child. Shared breastfeeding is a risk factor for HIV infection in infants. A woman who is engaged to breastfeed another's baby is known as a wet nurse. Islam has codified the relationship between this woman and the infants she nurses, and also between the infants when they grow up, so that milk siblings are considered as blood siblings and cannot marry (mahram). Shared breastfeeding can incur strong negative reactions in the Anglosphere; American feminist activist Jennifer Baumgardner has written about her experiences in New York with this issue.
Weaning
Weaning is the process of introducing the infant to other food and reducing the supply of breast milk. The infant is fully weaned when it no longer receives any breast milk. Most mammals stop producing the enzyme lactase at the end of weaning, and become lactose intolerant. Humans often have a mutation, with frequency depending primarily on ethnic background, that allows the production of lactase throughout life and so can drink milk - usually cow or goat milk - well beyond infancy.
In the past, bromocriptine was sometimes used to reduce the engorgement experienced by many women during weaning. However, it was discovered that when used for this purpose, this medication posed serious health risks to women such as stroke and seizures, and the U.S. Food and Drug Administration withdrew this indication for the drug in 1994.
Breast Feeding -7
Methods and considerations
There are many books and videos to advise mothers about breastfeeding. Lactation consultants in hospitals or private practice, and volunteer organisations of breastfeeding mothers such as La Leche League International also provide advice and support.
Early breastfeeding
In the half hour after birth, the baby's suckling reflex is strongest, and the baby is more alert, so it is the ideal time to start breastfeeding.[68] Early breast-feeding is associated with fewer nighttime feeding problems.[69]
Time and place for breastfeeding
Breastfeeding at least every two to three hours helps to maintain milk production. For most women, eight breastfeeding or pumping sessions every 24 hours keeps their milk production high.[8][not in citation given] Newborn babies may feed more often than this: 10 to 12 breastfeeding sessions every 24 hours is common, and some may even feed 18 times a day.[70] Feeding a baby "on demand" (sometimes referred to as "on cue"), means feeding when the baby shows signs of hunger; feeding this way rather than by the clock helps to maintain milk production and ensure the baby's needs for milk and comfort are being met.[citation needed] However, it may be important to recognize whether a baby is truly hungry, as breastfeeding too frequently may mean the child receives a disproportionately high amount of foremilk, and not enough hindmilk.[71]
"Experienced breastfeeding mothers learn that the sucking patterns and needs of babies vary. While some infants' sucking needs are met primarily during feedings, other babies may need additional sucking at the breast soon after a feeding even though they are not really hungry. Babies may also nurse when they are lonely, frightened or in pain."[72]
"Comforting and meeting sucking needs at the breast is nature's original design. Pacifiers (dummies, soothers) are a substitute for the mother when she can't be available. Other reasons to pacify a baby primarily at the breast include superior oral-facial development, prolonged lactational amenorrhea, avoidance of nipple confusion and stimulation of an adequate milk supply to ensure higher rates of breastfeeding success."
Rooming-in bassinetMost US states now have laws that allow a mother to breastfeed her baby anywhere she is allowed to be. In hospitals, rooming-in care permits the baby to stay with the mother and improves the ease of breastfeeding. Some commercial establishments provide breastfeeding rooms, although laws generally specify that mothers may breastfeed anywhere, without requiring them to go to a special area.
Latching on, feeding and positioning
This article contains instructions, advice, or how-to content. The purpose of Wikipedia is to present facts, not to train. Please help improve this article either by rewriting the how-to content or by moving it to Wikiversity or Wikibooks. (September 2008)
Correct positioning and technique for latching on can prevent nipple soreness and allow the baby to obtain enough milk. The "rooting reflex" is the baby's natural tendency to turn towards the breast with the mouth open wide; mothers sometimes make use of this by gently stroking the baby's cheek or lips with their nipple in order to induce the baby to move into position for a breastfeeding session, then quickly moving baby onto the breast while baby's mouth is wide open. In order to prevent nipple soreness and allow the baby to get enough milk, a large part of the breast and areola need to enter the baby's mouth. To help the baby latch on well, tickle the baby's top lip with the nipple, wait until the baby's mouth opens wide, then bring the baby up towards the nipple quickly, so that the baby has a mouthful of nipple and areola. The nipple should be at the back of the baby's throat, with the baby's tongue lying flat in its mouth. Inverted or flat nipples can be massaged so that the baby will have more to latch onto. Resist the temptation to move towards the baby, as this can lead to poor attachment.
Pain in the nipple or breast is linked to incorrect breastfeeding techniques. Failure to latch on is one of the main reasons for ineffective feeding and can lead to infant health concerns. A 2006 study found that inadequate parental education, incorrect breastfeeding techniques, or both were associated with higher rates of preventable hospital admissions in newborns.
The baby may pull away from the nipple after a few minutes or after a much longer period of time. Normal feeds at the breast can last a few sucks (newborns), from 10 to 20 minutes or even longer (on demand). Sometimes, after the finishing of a breast, the mother may offer the other breast.
While most women breastfeed their child in the cradling position, there are many ways to hold the feeding baby. It depends on the mother and child's comfort and the feeding preference of the baby. Some babies prefer one breast to the other, but the mother should offer both breasts at every nursing with her newborn.
When tandem breastfeeding, the mother is unable to move the baby from one breast to another and comfort can be more of an issue. As tandem breastfeeding brings extra strain to the arms, especially as the babies grow, many mothers of twins recommend the use of more supporting pillows.
There are many books and videos to advise mothers about breastfeeding. Lactation consultants in hospitals or private practice, and volunteer organisations of breastfeeding mothers such as La Leche League International also provide advice and support.
Early breastfeeding
In the half hour after birth, the baby's suckling reflex is strongest, and the baby is more alert, so it is the ideal time to start breastfeeding.[68] Early breast-feeding is associated with fewer nighttime feeding problems.[69]
Time and place for breastfeeding
Breastfeeding at least every two to three hours helps to maintain milk production. For most women, eight breastfeeding or pumping sessions every 24 hours keeps their milk production high.[8][not in citation given] Newborn babies may feed more often than this: 10 to 12 breastfeeding sessions every 24 hours is common, and some may even feed 18 times a day.[70] Feeding a baby "on demand" (sometimes referred to as "on cue"), means feeding when the baby shows signs of hunger; feeding this way rather than by the clock helps to maintain milk production and ensure the baby's needs for milk and comfort are being met.[citation needed] However, it may be important to recognize whether a baby is truly hungry, as breastfeeding too frequently may mean the child receives a disproportionately high amount of foremilk, and not enough hindmilk.[71]
"Experienced breastfeeding mothers learn that the sucking patterns and needs of babies vary. While some infants' sucking needs are met primarily during feedings, other babies may need additional sucking at the breast soon after a feeding even though they are not really hungry. Babies may also nurse when they are lonely, frightened or in pain."[72]
"Comforting and meeting sucking needs at the breast is nature's original design. Pacifiers (dummies, soothers) are a substitute for the mother when she can't be available. Other reasons to pacify a baby primarily at the breast include superior oral-facial development, prolonged lactational amenorrhea, avoidance of nipple confusion and stimulation of an adequate milk supply to ensure higher rates of breastfeeding success."
Rooming-in bassinetMost US states now have laws that allow a mother to breastfeed her baby anywhere she is allowed to be. In hospitals, rooming-in care permits the baby to stay with the mother and improves the ease of breastfeeding. Some commercial establishments provide breastfeeding rooms, although laws generally specify that mothers may breastfeed anywhere, without requiring them to go to a special area.
Latching on, feeding and positioning
This article contains instructions, advice, or how-to content. The purpose of Wikipedia is to present facts, not to train. Please help improve this article either by rewriting the how-to content or by moving it to Wikiversity or Wikibooks. (September 2008)
Correct positioning and technique for latching on can prevent nipple soreness and allow the baby to obtain enough milk. The "rooting reflex" is the baby's natural tendency to turn towards the breast with the mouth open wide; mothers sometimes make use of this by gently stroking the baby's cheek or lips with their nipple in order to induce the baby to move into position for a breastfeeding session, then quickly moving baby onto the breast while baby's mouth is wide open. In order to prevent nipple soreness and allow the baby to get enough milk, a large part of the breast and areola need to enter the baby's mouth. To help the baby latch on well, tickle the baby's top lip with the nipple, wait until the baby's mouth opens wide, then bring the baby up towards the nipple quickly, so that the baby has a mouthful of nipple and areola. The nipple should be at the back of the baby's throat, with the baby's tongue lying flat in its mouth. Inverted or flat nipples can be massaged so that the baby will have more to latch onto. Resist the temptation to move towards the baby, as this can lead to poor attachment.
Pain in the nipple or breast is linked to incorrect breastfeeding techniques. Failure to latch on is one of the main reasons for ineffective feeding and can lead to infant health concerns. A 2006 study found that inadequate parental education, incorrect breastfeeding techniques, or both were associated with higher rates of preventable hospital admissions in newborns.
The baby may pull away from the nipple after a few minutes or after a much longer period of time. Normal feeds at the breast can last a few sucks (newborns), from 10 to 20 minutes or even longer (on demand). Sometimes, after the finishing of a breast, the mother may offer the other breast.
While most women breastfeed their child in the cradling position, there are many ways to hold the feeding baby. It depends on the mother and child's comfort and the feeding preference of the baby. Some babies prefer one breast to the other, but the mother should offer both breasts at every nursing with her newborn.
When tandem breastfeeding, the mother is unable to move the baby from one breast to another and comfort can be more of an issue. As tandem breastfeeding brings extra strain to the arms, especially as the babies grow, many mothers of twins recommend the use of more supporting pillows.
Breast Feeding -6
Breastfeeding difficulties
Main article: Breastfeeding difficulties
While breastfeeding is a natural human activity, difficulties are not uncommon. Putting the baby to the breast as soon as possible after the birth helps to avoid many problems. The AAP breastfeeding policy says: "Delay weighing, measuring, bathing, needle-sticks, and eye prophylaxis until after the first feeding is completed." Many breastfeeding difficulties can be resolved with proper hospital procedures, properly trained midwives, doctors and hospital staff, and lactation consultants. There are some situations in which breastfeeding may be harmful to the infant, including infection with HIV and acute poisoning by environmental contaminants such as lead. The Institute of Medicine has reported that breast surgery, including breast implants or breast reduction surgery, reduces the chances that a woman will have sufficient milk to breast feed. Rarely, a mother may not be able to produce breastmilk because of a prolactin deficiency. This may be caused by Sheehan's syndrome, an uncommon result of a sudden drop in blood pressure during childbirth typically due to hemorrhaging. In developed countries, many working mothers do not breast feed their children due to work pressures. For example, a mother may need to schedule for frequent pumping breaks, and find a clean, private and quiet place at work for pumping. These inconveniences may cause mothers to give up on breast feeding and use infant formula instead.
HIV infection
As breastfeeding can transmit HIV from mother to child, UNAIDS recommends avoidance of all breastfeeding where formula feeding is acceptable, feasible, affordable and safe. The qualifications are important. Some constituents of breast milk may protect from infection. High levels of certain polyunsaturated fatty acids in breast milk (including eicosadienoic, arachidonic and gamma-linolenic acids) are associated with a reduced risk of child infection when nursed by HIV-positive mothers. Arachidonic acid and gamma-linolenic acid may also reduce viral shedding of the HIV virus in breast milk. Due to this, in underdeveloped nations infant mortality rates are lower when HIV-positive mothers breastfeed their newborns than when they use infant formula. However, differences in infant mortality rates have not been reported in better resourced areas. Treating infants prophylactically with lamivudine (3TC) can help to decrease the transmission of HIV from mother to child by breastfeeding. If free or subsidized formula is given to HIV-infected mothers, recommendations have been made to minimize the drawbacks such as possible disclosure of the mother's HIV status.
Infant weight gain
Breastfed infants generally gain weight according to the following guidelines:
0–4 months: 170 grams per week†
4–6 months: 113–142 grams per week
6–12 months: 57–113 grams per week
† It is acceptable for some babies to gain 113–142 grams (4–5 ounces) per week. This average is taken from the lowest weight, not the birth weight.
The average breastfed baby doubles its birth weight in 5–6 months. By one year, a typical breastfed baby will weigh about 2½ times its birth weight. At one year, breastfed babies tend to be leaner than bottle fed babies. By two years, differences in weight gain and growth between breastfed and formula-fed babies are no longer evident.
Main article: Breastfeeding difficulties
While breastfeeding is a natural human activity, difficulties are not uncommon. Putting the baby to the breast as soon as possible after the birth helps to avoid many problems. The AAP breastfeeding policy says: "Delay weighing, measuring, bathing, needle-sticks, and eye prophylaxis until after the first feeding is completed." Many breastfeeding difficulties can be resolved with proper hospital procedures, properly trained midwives, doctors and hospital staff, and lactation consultants. There are some situations in which breastfeeding may be harmful to the infant, including infection with HIV and acute poisoning by environmental contaminants such as lead. The Institute of Medicine has reported that breast surgery, including breast implants or breast reduction surgery, reduces the chances that a woman will have sufficient milk to breast feed. Rarely, a mother may not be able to produce breastmilk because of a prolactin deficiency. This may be caused by Sheehan's syndrome, an uncommon result of a sudden drop in blood pressure during childbirth typically due to hemorrhaging. In developed countries, many working mothers do not breast feed their children due to work pressures. For example, a mother may need to schedule for frequent pumping breaks, and find a clean, private and quiet place at work for pumping. These inconveniences may cause mothers to give up on breast feeding and use infant formula instead.
HIV infection
As breastfeeding can transmit HIV from mother to child, UNAIDS recommends avoidance of all breastfeeding where formula feeding is acceptable, feasible, affordable and safe. The qualifications are important. Some constituents of breast milk may protect from infection. High levels of certain polyunsaturated fatty acids in breast milk (including eicosadienoic, arachidonic and gamma-linolenic acids) are associated with a reduced risk of child infection when nursed by HIV-positive mothers. Arachidonic acid and gamma-linolenic acid may also reduce viral shedding of the HIV virus in breast milk. Due to this, in underdeveloped nations infant mortality rates are lower when HIV-positive mothers breastfeed their newborns than when they use infant formula. However, differences in infant mortality rates have not been reported in better resourced areas. Treating infants prophylactically with lamivudine (3TC) can help to decrease the transmission of HIV from mother to child by breastfeeding. If free or subsidized formula is given to HIV-infected mothers, recommendations have been made to minimize the drawbacks such as possible disclosure of the mother's HIV status.
Infant weight gain
Breastfed infants generally gain weight according to the following guidelines:
0–4 months: 170 grams per week†
4–6 months: 113–142 grams per week
6–12 months: 57–113 grams per week
† It is acceptable for some babies to gain 113–142 grams (4–5 ounces) per week. This average is taken from the lowest weight, not the birth weight.
The average breastfed baby doubles its birth weight in 5–6 months. By one year, a typical breastfed baby will weigh about 2½ times its birth weight. At one year, breastfed babies tend to be leaner than bottle fed babies. By two years, differences in weight gain and growth between breastfed and formula-fed babies are no longer evident.
Breast Feeding -5
Long-term health effects
For breastfeeding women, long-term health benefits include:
Less risk of breast cancer, ovarian cancer, and endometrial cancer.
A 2009 study indicates long duration of lactation (at least 24 months) is associated with a reduced risk of heart disease.
Although the 2007 review for the AHRQ found "no relationship between a history of lactation and the risk of osteoporosis", mothers who breastfeed longer than eight months benefit from bone re-mineralisation.
Breastfeeding diabetic mothers require less insulin.
Reduced risk of post-partum bleeding.
According to a Malmö University study published in 2009, women who breast fed for a longer duration have a lower risk for contracting rheumatoid arthritis than women who breast fed for a shorter duration or who had never breast fed.
Organisational endorsements
World Health Organization
“ The vast majority of mothers can and should breastfeed, just as the vast majority of infants can and should be breastfed. Only under exceptional circumstances can a mother’s milk be considered unsuitable for her infant. For those few health situations where infants cannot, or should not, be breastfed, the choice of the best alternative – expressed breast milk from an infant’s own mother, breast milk from a healthy wet-nurse or a human-milk bank, or a breast-milk substitute fed with a cup, which is a safer method than a feeding bottle and teat – depends on individual circumstances. ”
The WHO recommends exclusive breastfeeding for the first six months of life, after which "infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond."
American Academy of Pediatrics
“ Extensive research using improved epidemiologic methods and modern laboratory techniques documents diverse and compelling advantages for infants, mothers, families, and society from breastfeeding and use of human milk for infant feeding. These advantages include health, nutritional, immunologic, developmental, psychologic, social, economic, and environmental benefits. ”
The AAP recommends exclusive breastfeeding for the first six months of life. Furthermore, "breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child."
For breastfeeding women, long-term health benefits include:
Less risk of breast cancer, ovarian cancer, and endometrial cancer.
A 2009 study indicates long duration of lactation (at least 24 months) is associated with a reduced risk of heart disease.
Although the 2007 review for the AHRQ found "no relationship between a history of lactation and the risk of osteoporosis", mothers who breastfeed longer than eight months benefit from bone re-mineralisation.
Breastfeeding diabetic mothers require less insulin.
Reduced risk of post-partum bleeding.
According to a Malmö University study published in 2009, women who breast fed for a longer duration have a lower risk for contracting rheumatoid arthritis than women who breast fed for a shorter duration or who had never breast fed.
Organisational endorsements
World Health Organization
“ The vast majority of mothers can and should breastfeed, just as the vast majority of infants can and should be breastfed. Only under exceptional circumstances can a mother’s milk be considered unsuitable for her infant. For those few health situations where infants cannot, or should not, be breastfed, the choice of the best alternative – expressed breast milk from an infant’s own mother, breast milk from a healthy wet-nurse or a human-milk bank, or a breast-milk substitute fed with a cup, which is a safer method than a feeding bottle and teat – depends on individual circumstances. ”
The WHO recommends exclusive breastfeeding for the first six months of life, after which "infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond."
American Academy of Pediatrics
“ Extensive research using improved epidemiologic methods and modern laboratory techniques documents diverse and compelling advantages for infants, mothers, families, and society from breastfeeding and use of human milk for infant feeding. These advantages include health, nutritional, immunologic, developmental, psychologic, social, economic, and environmental benefits. ”
The AAP recommends exclusive breastfeeding for the first six months of life. Furthermore, "breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child."
Breast Feeding -4
A review of the association between breastfeeding and celiac disease (CD) concluded that breast feeding while introducing gluten to the diet reduced the risk of CD. The study was unable to determine if breastfeeding merely delayed symptoms or offered life-long protection.
An initial study at the University of Wisconsin found that women who were breast fed in infancy may have a lower risk of developing breast cancer than those who were not breast fed.
Breastfeeding may decrease the risk of cardiovascular disease in later life, as indicated by lower cholesterol and C-reactive protein levels in adult women who had been breastfed as infants. Although a 2001 study suggested that adults who had been breastfed as infants had lower arterial distensibility than adults who had not been breastfed as infants, the 2007 review for the WHO concluded that breastfed infants "experienced lower mean blood pressure" later in life. Nevertheless, the 2007 review for the AHRQ found that "the relationship between breastfeeding and cardiovascular diseases was unclear"
Benefits for mothers
Zanzibari woman breastfeedingBreastfeeding is a cost effective way of feeding an infant, and provides the best nourishment for a child at a small nutrient cost to the mother. Frequent and exclusive breastfeeding can delay the return of fertility through lactational amenorrhea, though breastfeeding is an imperfect means of birth control. During breastfeeding beneficial hormones are released into the mother's body[15] and the maternal bond can be strengthened. Breastfeeding is possible throughout pregnancy, but generally milk production will be reduced at some point.
Bonding
Hormones released during breastfeeding help to strengthen the maternal bond. Teaching partners how to manage common difficulties is associated with higher breastfeeding rates. Support for a mother while breastfeeding can assist in familial bonds and help build a paternal bond between father and child.
If the mother is away, an alternative caregiver may be able to feed the baby with expressed breast milk. The various breast pumps available for sale and rent help working mothers to feed their babies breast milk for as long as they want. To be successful, the mother must produce and store enough milk to feed the child for the time she is away, and the feeding caregiver must be comfortable in handling breast milk.
Hormone release
Breastfeeding releases oxytocin and prolactin, hormones that relax the mother and make her feel more nurturing toward her baby.[48] Breastfeeding soon after giving birth increases the mother's oxytocin levels, making her uterus contract more quickly and reducing bleeding. Pitocin, a synthetic hormone used to make the uterus contract during and after labour, is structurally modelled on oxytocin.
Weight loss
As the fat accumulated during pregnancy is used to produce milk, extended breastfeeding—at least 6 months—can help mothers lose weight. However, weight loss is highly variable among lactating women; monitoring the diet and increasing the amount/intensity of exercise are more reliable ways of losing weight. The 2007 review for the AHRQ found "The effect of breastfeeding in mothers on return-to-pre-pregnancy weight was negligible, and the effect of breastfeeding on postpartum weight loss was unclear."
Natural postpartum infertility
A breastfeeding woman may not ovulate, or have regular periods, during the entire lactation period. The period in which ovulation is absent differs for each woman. This Lactational amenorrhea has been used as an imperfect form of natural contraception, with a greater than 98% effectiveness during the first six months after birth if specific nursing behaviors are followed. It is possible for some women to ovulate within two months after birth while fully breastfeeding.
Breast Feeding -3
Higher intelligence
Studies examining whether breastfeeding in infants is associated with higher intelligence later in life include:
Horwood, Darlow and Mogridge (2001) tested the intelligence quotient (IQ) scores of 280 low birthweight children at seven or eight years of age.[28] Those who were breastfed for more than eight months had verbal IQ scores 6 points higher (which was significantly higher) than comparable children breastfed for less time.[28] They concluded "These findings add to a growing body of evidence to suggest that breast milk feeding may have small long term benefits for child cognitive development."[28]
A 2005 study using data on 2,734 sibling pairs from the National Longitudinal Study of Adolescent Health "provide[d] persuasive evidence of a causal connection between breastfeeding and intelligence."[29]
In 2006, Der and colleagues, having performed a prospective cohort study, sibling pairs analysis, and meta-analysis, concluded that "Breast feeding has little or no effect on intelligence in children."[30] The researchers found that "Most of the observed association between breast feeding and cognitive development is the result of confounding by maternal intelligence."[30]
The 2007 review for the AHRQ found "no relationship between breastfeeding in term infants and cognitive performance."[12]
The 2007 review for the WHO concluded "Subjects who were breastfed experienced... higher performance in intelligence tests."[13]
Two initial cohort studies published in 2007 suggest babies with a specific version of the FADS2 gene demonstrated an IQ averaging 7 points higher if breastfed, compared with babies with a less common version of the gene who showed no improvement when breastfed.[31] FADS2 affects the metabolism of polyunsaturated fatty acids found in human breast milk, such as docosahexaenoic acid and arachidonic acid, which are known to be linked to early brain development.[31] The researchers were quoted as saying "Our findings support the idea that the nutritional content of breast milk accounts for the differences seen in human IQ. But it's not a simple all-or-none connection: it depends to some extent on the genetic makeup of each infant."[32] The researchers wrote "further investigation to replicate and explain this specific gene–environment interaction is warranted."[31]
In "the largest randomized trial ever conducted in the area of human lactation," between 1996 and 1997 maternity hospitals and polyclinics in Belarus were randomized to receive or not receive breastfeeding promotion modeled on the Baby Friendly Hospital Initiative.[33] Of 13,889 infants born at these hospitals and polyclinics and followed up in 2002-2005, those who had been born in hospitals and polyclinics receiving breastfeeding promotion had IQs that were 2.9-7.5 points higher (which was significantly higher).[33] Since (among other reasons) a randomized trial should control for maternal IQ, the authors concluded in a 2008 paper that the data "provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development."[33]
Diabetes
Infants exclusively breastfed have less chance of developing diabetes mellitus type 1 than peers with a shorter duration of breastfeeding and an earlier exposure to cow milk and solid foods.[12][34] Breastfeeding also appears to protect against diabetes mellitus type 2,[12][13][35][36] at least in part due to its effects on the child's weight.[36]
Obesity
Breastfeeding appears to reduce the risk of extreme obesity in children aged 39 to 42 months. The protective effect of breastfeeding against obesity is consistent, though small, across many studies, and appears to increase with the duration of breastfeeding.
Other long term health effects
In one study, breastfeeding did not appear to offer protection against allergies. However, another study showed breastfeeding to have lowered the risk of asthma, protect against allergies, and provide improved protection for babies against respiratory and intestinal infections.
Studies examining whether breastfeeding in infants is associated with higher intelligence later in life include:
Horwood, Darlow and Mogridge (2001) tested the intelligence quotient (IQ) scores of 280 low birthweight children at seven or eight years of age.[28] Those who were breastfed for more than eight months had verbal IQ scores 6 points higher (which was significantly higher) than comparable children breastfed for less time.[28] They concluded "These findings add to a growing body of evidence to suggest that breast milk feeding may have small long term benefits for child cognitive development."[28]
A 2005 study using data on 2,734 sibling pairs from the National Longitudinal Study of Adolescent Health "provide[d] persuasive evidence of a causal connection between breastfeeding and intelligence."[29]
In 2006, Der and colleagues, having performed a prospective cohort study, sibling pairs analysis, and meta-analysis, concluded that "Breast feeding has little or no effect on intelligence in children."[30] The researchers found that "Most of the observed association between breast feeding and cognitive development is the result of confounding by maternal intelligence."[30]
The 2007 review for the AHRQ found "no relationship between breastfeeding in term infants and cognitive performance."[12]
The 2007 review for the WHO concluded "Subjects who were breastfed experienced... higher performance in intelligence tests."[13]
Two initial cohort studies published in 2007 suggest babies with a specific version of the FADS2 gene demonstrated an IQ averaging 7 points higher if breastfed, compared with babies with a less common version of the gene who showed no improvement when breastfed.[31] FADS2 affects the metabolism of polyunsaturated fatty acids found in human breast milk, such as docosahexaenoic acid and arachidonic acid, which are known to be linked to early brain development.[31] The researchers were quoted as saying "Our findings support the idea that the nutritional content of breast milk accounts for the differences seen in human IQ. But it's not a simple all-or-none connection: it depends to some extent on the genetic makeup of each infant."[32] The researchers wrote "further investigation to replicate and explain this specific gene–environment interaction is warranted."[31]
In "the largest randomized trial ever conducted in the area of human lactation," between 1996 and 1997 maternity hospitals and polyclinics in Belarus were randomized to receive or not receive breastfeeding promotion modeled on the Baby Friendly Hospital Initiative.[33] Of 13,889 infants born at these hospitals and polyclinics and followed up in 2002-2005, those who had been born in hospitals and polyclinics receiving breastfeeding promotion had IQs that were 2.9-7.5 points higher (which was significantly higher).[33] Since (among other reasons) a randomized trial should control for maternal IQ, the authors concluded in a 2008 paper that the data "provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development."[33]
Diabetes
Infants exclusively breastfed have less chance of developing diabetes mellitus type 1 than peers with a shorter duration of breastfeeding and an earlier exposure to cow milk and solid foods.[12][34] Breastfeeding also appears to protect against diabetes mellitus type 2,[12][13][35][36] at least in part due to its effects on the child's weight.[36]
Obesity
Breastfeeding appears to reduce the risk of extreme obesity in children aged 39 to 42 months. The protective effect of breastfeeding against obesity is consistent, though small, across many studies, and appears to increase with the duration of breastfeeding.
Other long term health effects
In one study, breastfeeding did not appear to offer protection against allergies. However, another study showed breastfeeding to have lowered the risk of asthma, protect against allergies, and provide improved protection for babies against respiratory and intestinal infections.
Breast Feeding -2
Greater immune health
During breastfeeding antibodies pass to the baby. Breast milk contains several anti-infective factors such as bile salt stimulated lipase (protecting against amoebic infections), lactoferrin (which binds to iron and inhibits the growth of intestinal bacteria)and imm unoglobulin A protecting against microorganisms.
Fewer infections
Among the studies showing that breastfed infants have a lower risk of infection than non-breastfed infants are:
In a 1993 University of Texas Medical Branch study, a longer period of breastfeeding was associated with a shorter duration of some middle ear infections (otitis media with effusion) in the first two years of life.
A 1995 study of 87 infants found that breastfed babies had half the incidence of diarrheal illness, 19% fewer cases of any otitis media infection, and 80% fewer prolonged cases of otitis media than formula fed babies in the first twelve months of life.
Breastfeeding appeared to reduce symptoms of upper respiratory tract infections in premature infants up to seven months after release from hospital in a 2002 study of 39 infants.
A 2004 case-control study found that breastfeeding reduced the risk of acquiring urinary tract infections in infants up to seven months of age, with the protection strongest immediately after birth.
The 2007 review for AHRQ found that breastfeeding reduced the risk of acute otitis media, non-specific gastroenteritis, and severe lower respiratory tract infections.
Less tendency to develop allergic diseases (atopy)
In children who are at risk for developing allergic diseases (defined as at least one parent or sibling having atopy), atopic syndrome can be prevented or delayed through exclusive breastfeeding for four months, though these benefits may not be present after four months of age. However, the key factor may be the age at which non-breastmilk is introduced rather than duration of breastfeeding. Atopic dermatitis, the most common form of eczema, can be reduced through exclusive breastfeeding beyond 12 weeks in individuals with a family history of atopy, but when breastfeeding beyond 12 weeks is combined with other foods incidents of eczema rise irrespective of family history.
Protection from SIDS
Breastfed babies have better arousal from sleep at 2–3 months. This coincides with the peak incidence of sudden infant death syndrome.[26] Study conducted in University of Münster has shown that breastfeeding reduces the risk of sudden infant death syndrome by approximately 50% at all ages throughout infancy.
During breastfeeding antibodies pass to the baby. Breast milk contains several anti-infective factors such as bile salt stimulated lipase (protecting against amoebic infections), lactoferrin (which binds to iron and inhibits the growth of intestinal bacteria)and imm unoglobulin A protecting against microorganisms.
Fewer infections
Among the studies showing that breastfed infants have a lower risk of infection than non-breastfed infants are:
In a 1993 University of Texas Medical Branch study, a longer period of breastfeeding was associated with a shorter duration of some middle ear infections (otitis media with effusion) in the first two years of life.
A 1995 study of 87 infants found that breastfed babies had half the incidence of diarrheal illness, 19% fewer cases of any otitis media infection, and 80% fewer prolonged cases of otitis media than formula fed babies in the first twelve months of life.
Breastfeeding appeared to reduce symptoms of upper respiratory tract infections in premature infants up to seven months after release from hospital in a 2002 study of 39 infants.
A 2004 case-control study found that breastfeeding reduced the risk of acquiring urinary tract infections in infants up to seven months of age, with the protection strongest immediately after birth.
The 2007 review for AHRQ found that breastfeeding reduced the risk of acute otitis media, non-specific gastroenteritis, and severe lower respiratory tract infections.
Less tendency to develop allergic diseases (atopy)
In children who are at risk for developing allergic diseases (defined as at least one parent or sibling having atopy), atopic syndrome can be prevented or delayed through exclusive breastfeeding for four months, though these benefits may not be present after four months of age. However, the key factor may be the age at which non-breastmilk is introduced rather than duration of breastfeeding. Atopic dermatitis, the most common form of eczema, can be reduced through exclusive breastfeeding beyond 12 weeks in individuals with a family history of atopy, but when breastfeeding beyond 12 weeks is combined with other foods incidents of eczema rise irrespective of family history.
Protection from SIDS
Breastfed babies have better arousal from sleep at 2–3 months. This coincides with the peak incidence of sudden infant death syndrome.[26] Study conducted in University of Münster has shown that breastfeeding reduces the risk of sudden infant death syndrome by approximately 50% at all ages throughout infancy.
Breast Feeding -1
Breast milk
Main article: Breast milk
Himba woman and child.Not all the properties of breast milk are understood, but its nutrient content is relatively stable. Breast milk is made from nutrients in the mother's bloodstream and bodily stores. Breast milk has just the right amount of fat, sugar, water, and protein that is needed for a baby's growth and development. Because breastfeeding uses an average of 500 calories a day it helps the mother lose weight after giving birth. The composition of breast milk changes depending on how long the baby nurses at each session, as well as on the age of the child. The quality of a mother's breast milk may be compromised by smoking, and drinking.
Benefits for the infant
A woman with her child in Kabala, Sierra Leone in the 1960's.Scientific research, such as the studies summarized in a 2007 review for the U.S. Agency for Healthcare Research and Quality (AHRQ) and a 2007 review for the WHO[13], has found many benefits to breastfeeding for the infant. These include:
Less necrotizing enterocolitis in premature infants
Necrotizing enterocolitis (NEC) is an acute inflammatory disease in the intestines of infants. Necrosis or death of intestinal tissue may follow. It is mainly found in premature births. In one study of 926 preterm infants, NEC developed in 51 infants (5.5%). The death rate from necrotizing enterocolitis was 26%. NEC was found to be six to ten times more common in infants fed formula exclusively, and three times more common in infants fed a mixture of breast milk and formula, compared with exclusive breastfeeding. In infants born at more than 30 weeks, NC was twenty times more common in infants fed exclusively on formula.[14] A 2007 meta-analysis of four randomized controlled trials found "a marginally statistically significant association" between breastfeeding and a reduction in the risk of NEC.
Greater immune health
During breastfeeding antibodies pass to the baby. Breast milk contains several anti-infective factors such as bile salt stimulated lipase (protecting against amoebic infections), lactoferrin (which binds to iron and inhibits the growth of intestinal bacteria) and immunoglobulin A protecting against microorganisms.
Tuesday, February 16, 2010
White Paper on early symptoms of breast cancer-1
1, In the early stage, some breast cancer patients are not able to touch a clear mass on their breasts, but often feel some isolated discomforts. Especially in post-menopausal women, they sometimes feel the side of the breast pain and mild discomfort, or the side of the shoulders and back shoulder very heavy, sour and painful, and even have difficulty in pulling up her arm on one side.
2, Early breast palpable mass is the size of broad beans, hard, movable, usually having no obvious pain, but a small number patients will feel paroxysmal pain, dull pain, or tingling.
3, Breast shape changes: visible swelling on the skin, and some parts of skin was orange peel-like, and even edema, discoloration, eczema-like changes and so on.
Monday, February 15, 2010
personality / interest / exploration
2 year old explorer.
How does a 2-year-old toddler spend his time? He will run, will bounce, will talk and since he is full of energy, he also will touch, will move, will explore. What is he interested in?
For a 2-year-old child, their exploration interest is primarily in the relationship between the object and the object, especially their causal relationships. A one-year-old child just like to use your fingers to explore caves, holes, while a two-year-old children would like to know things related with these caves, holes, such as the relation between a wall plug seat and the plug of a TV set, a TV's remote control panel and what shown on the TV screen. A one-year-old in general will hold a pen and doodle on paper, while a 2-year-old will attempt to consciously draw on the wall, bed sheets, and all kinds of surface. He wanted to see the different effects on the different things with his pen. Given electric or mechanical toys, a two-year-old will like to play for a while, then start to press here, squeeze there, shake and even punch it. He starts being curious about why the car can run, and why the cub can drum. In fact, the consciousness of operation is a major feature for kids of this age. Parents don¡¯t need to buy 2-year-olds expensive toys, because they will soon destroy them to satisfy their exploration. Assembling toys are the best choice for them to fulfill their exploring desires.
In addition, a 2-year-old child will like to the chair and climb up the table or windowsill to enjoy the excitement of looking down from above. They are also interested in scissors, knifes and other household items, so parents need to remember store all dangerous items safely and away from the little explorers. Therefore, parents should create a safe, colorful environment for children to play, do not be overprotective, inhibiting the child¡¯s attempts of exploring and studying the outside world. Protect your children reasonably, give them freedom but in a safe environment. All these will encourage your children being independence, and build up self-confidence.
Sunday, February 14, 2010
Pregnancy-7
Management
See also: Prenatal care
Prenatal medical care is of recognized value throughout the developed world. Periconceptional folic acid supplementation is the only type of supplementation of proven efficacy.[citation needed]
Nutrition
Main article: Nutrition and pregnancy
A balanced, nutritious diet is an important aspect of a healthy pregnancy. Eating a healthy diet, balancing carbohydrates, fat, and proteins, and eating a variety of fruits and vegetables, usually ensures good nutrition. Those whose diets are affected by health issues, religious requirements, or ethical beliefs may choose to consult a health professional for specific advice.
Adequate periconceptional folic acid (also called folate or Vitamin B9) intake has been proven to limit fetal neural tube defects, preventing spina bifida, a very serious birth defect. The neural tube develops during the first 28 days of pregnancy, explaining the necessity to guarantee adequate periconceptional folate intake. Folates (from folia, leaf) are abundant in spinach (fresh, frozen, or canned), and are also found in green vegetables, salads, citrus fruit and melon, chickpeas (i.e. in the form of hummus or falafel), and eggs. In the United States and Canada, most wheat products (flour, noodles) are fortified with folic acid.
DHA omega-3 is a major structural fatty acid in the brain and retina, and is naturally found in breast milk. It is important for a mother to consume adequate amounts of DHA during pregnancy and while nursing to support her well-being and the health of her infant. Developing infants cannot produce DHA efficiently, and must receive this vital nutrient from the mother through the placenta during pregnancy and in breast milk after birth.
Several micronutrients are important for the health of the developing fetus, especially in areas of the world where insufficient nutrition is prevalent.[46] In developed areas, such as Western Europe and the United States, certain nutrients such as Vitamin D and calcium, required for bone development, may require supplementation.
Dangerous bacteria or parasites may contaminate foods, particularly listeria and toxoplasma, toxoplasmosis agent. Careful washing of fruits and raw vegetables may remove these pathogens, as may thoroughly cooking leftovers, meat, or processed meat. Soft cheeses may contain listeria; if milk is raw the risk may increase. Cat feces pose a particular risk of toxoplasmosis. Pregnant women are also more prone to catching salmonella infections from eggs and poultry, which should be thoroughly cooked. Practicing good hygiene in the kitchen can reduce these risks.
Weight gain
Caloric intake must be increased to ensure proper development of the fetus. The amount of weight gained during pregnancy varies among women. The National Health Service recommends that overall weight gain during the 9 month period for women who start pregnancy with normal weight be 10 to 12 kilograms (22–26 lb). During pregnancy, insufficient weight gain can compromise the health of the fetus. Likewise, excessive weight gain can pose risks to the woman and the fetus. Women who are prone to being overweight may choose to plan a healthy diet and exercise to help moderate the amount of weight gained.
Immune tolerance
Main article: Immune tolerance in pregnancy
The fetus inside a mother may be viewed as an unusually successful allograft, since it genetically differs from the mother. In the same way, many cases of spontaneous abortion may be described in the same way as maternal transplant rejection.
Drugs in pregnancy
Main article: Drugs in pregnancy
Drugs used during pregnancy can have temporary or permanent effects on the fetus. Therefore many physicians would prefer not to prescribe for pregnant women, the major concern being over teratogenicity of the drugs. This results in inappropriate treatment of pregnant women. Use of drugs in pregnancy is not always wrong. For example, high fever is harmful for the fetus in the early months. Use of paracetamol is better than no treatment at all. Also, diabetes mellitus during pregnancy may need intensive therapy with insulin. Drugs have been classified into categories A,B,C,D and X based on the Food and Drug Administration (FDA) rating system to provide therapeutic guidance based on potential benefits and fetal risks. Drugs like multivitamins that have demonstrated no fetal risks after controlled studies in humans are classified as Category A. On the other hand drugs like thalidomide with proven fetal risks that outweigh all benefits are classified as Category X.
Exposure to toxins
Various toxins pose a significant hazard to fetuses during development:
Alcohol ingestion during pregnancy may cause fetal alcohol syndrome, a permanent and often devastating birth-defect syndrome. A number of studies have shown that light to moderate drinking during pregnancy might not pose a risk to the fetus, although no amount of alcohol during pregnancy can be guaranteed to be absolutely safe.
Women who have suffered mercury poisoning in pregnancy have sometimes given birth to children with serious birth defects, termed Minamata disease.
Sexual activity during pregnancy
Most pregnant women can enjoy sexual activity during pregnancy throughout gravidity. Most research suggests that, during pregnancy, both sexual desire and frequency of sexual relations decrease.[57][58] In context of this overall decrease in desire, some studies indicate a second-trimester increase, preceding a decrease. However, these decreases are not universal: a significant number of women report greater sexual satisfaction throughout their pregnancies.
Abortion
Main article: Abortion
An abortion is the removal or expulsion of an embryo or fetus from the uterus, resulting in or caused by its death. This can occur spontaneously or accidentally as with a miscarriage, or be artificially induced by medical, surgical or other means
See also: Prenatal care
Prenatal medical care is of recognized value throughout the developed world. Periconceptional folic acid supplementation is the only type of supplementation of proven efficacy.[citation needed]
Nutrition
Main article: Nutrition and pregnancy
A balanced, nutritious diet is an important aspect of a healthy pregnancy. Eating a healthy diet, balancing carbohydrates, fat, and proteins, and eating a variety of fruits and vegetables, usually ensures good nutrition. Those whose diets are affected by health issues, religious requirements, or ethical beliefs may choose to consult a health professional for specific advice.
Adequate periconceptional folic acid (also called folate or Vitamin B9) intake has been proven to limit fetal neural tube defects, preventing spina bifida, a very serious birth defect. The neural tube develops during the first 28 days of pregnancy, explaining the necessity to guarantee adequate periconceptional folate intake. Folates (from folia, leaf) are abundant in spinach (fresh, frozen, or canned), and are also found in green vegetables, salads, citrus fruit and melon, chickpeas (i.e. in the form of hummus or falafel), and eggs. In the United States and Canada, most wheat products (flour, noodles) are fortified with folic acid.
DHA omega-3 is a major structural fatty acid in the brain and retina, and is naturally found in breast milk. It is important for a mother to consume adequate amounts of DHA during pregnancy and while nursing to support her well-being and the health of her infant. Developing infants cannot produce DHA efficiently, and must receive this vital nutrient from the mother through the placenta during pregnancy and in breast milk after birth.
Several micronutrients are important for the health of the developing fetus, especially in areas of the world where insufficient nutrition is prevalent.[46] In developed areas, such as Western Europe and the United States, certain nutrients such as Vitamin D and calcium, required for bone development, may require supplementation.
Dangerous bacteria or parasites may contaminate foods, particularly listeria and toxoplasma, toxoplasmosis agent. Careful washing of fruits and raw vegetables may remove these pathogens, as may thoroughly cooking leftovers, meat, or processed meat. Soft cheeses may contain listeria; if milk is raw the risk may increase. Cat feces pose a particular risk of toxoplasmosis. Pregnant women are also more prone to catching salmonella infections from eggs and poultry, which should be thoroughly cooked. Practicing good hygiene in the kitchen can reduce these risks.
Weight gain
Caloric intake must be increased to ensure proper development of the fetus. The amount of weight gained during pregnancy varies among women. The National Health Service recommends that overall weight gain during the 9 month period for women who start pregnancy with normal weight be 10 to 12 kilograms (22–26 lb). During pregnancy, insufficient weight gain can compromise the health of the fetus. Likewise, excessive weight gain can pose risks to the woman and the fetus. Women who are prone to being overweight may choose to plan a healthy diet and exercise to help moderate the amount of weight gained.
Immune tolerance
Main article: Immune tolerance in pregnancy
The fetus inside a mother may be viewed as an unusually successful allograft, since it genetically differs from the mother. In the same way, many cases of spontaneous abortion may be described in the same way as maternal transplant rejection.
Drugs in pregnancy
Main article: Drugs in pregnancy
Drugs used during pregnancy can have temporary or permanent effects on the fetus. Therefore many physicians would prefer not to prescribe for pregnant women, the major concern being over teratogenicity of the drugs. This results in inappropriate treatment of pregnant women. Use of drugs in pregnancy is not always wrong. For example, high fever is harmful for the fetus in the early months. Use of paracetamol is better than no treatment at all. Also, diabetes mellitus during pregnancy may need intensive therapy with insulin. Drugs have been classified into categories A,B,C,D and X based on the Food and Drug Administration (FDA) rating system to provide therapeutic guidance based on potential benefits and fetal risks. Drugs like multivitamins that have demonstrated no fetal risks after controlled studies in humans are classified as Category A. On the other hand drugs like thalidomide with proven fetal risks that outweigh all benefits are classified as Category X.
Exposure to toxins
Various toxins pose a significant hazard to fetuses during development:
Alcohol ingestion during pregnancy may cause fetal alcohol syndrome, a permanent and often devastating birth-defect syndrome. A number of studies have shown that light to moderate drinking during pregnancy might not pose a risk to the fetus, although no amount of alcohol during pregnancy can be guaranteed to be absolutely safe.
Women who have suffered mercury poisoning in pregnancy have sometimes given birth to children with serious birth defects, termed Minamata disease.
Sexual activity during pregnancy
Most pregnant women can enjoy sexual activity during pregnancy throughout gravidity. Most research suggests that, during pregnancy, both sexual desire and frequency of sexual relations decrease.[57][58] In context of this overall decrease in desire, some studies indicate a second-trimester increase, preceding a decrease. However, these decreases are not universal: a significant number of women report greater sexual satisfaction throughout their pregnancies.
Abortion
Main article: Abortion
An abortion is the removal or expulsion of an embryo or fetus from the uterus, resulting in or caused by its death. This can occur spontaneously or accidentally as with a miscarriage, or be artificially induced by medical, surgical or other means
Pregnancy-6
Physiological changes in pregnancy
The body must change its physiological and homeostatic mechanisms in pregnancy to ensure the fetus is provided for. Increases in blood sugar, breathing and cardiac output are all required.[citation needed]
Hormonal changes
Levels of progesterone and estrogens rise continually throughout pregnancy, suppressing the hypothalamic axis and subsequently the menstrual cycle. The woman and the placenta also produce many hormones.
Prolactin levels increase due to maternal Pituitary gland enlargement by 50%. This mediates a change in the structure of the Mammary gland from ductal to lobular-alveolar. Parathyroid hormone is increased which leads to increases of calcium uptake in the gut and reabsorption by the kidney. Adrenal hormones such as cortisol and aldosterone also increase.
Placental lactogen is produced by the placenta and stimulates lipolysis and fatty acid metabolism by the woman, conserving blood glucose for use by the fetus. It can also decrease maternal tissue sensitivity to insulin, resulting in gestational diabetes.[citation needed]
Musculoskeletal changes
The body's posture changes as the pregnancy progresses. The pelvis tilts and the back arches to help keep balance. Poor posture occurs naturally from the stretching of the woman's abdominal muscles as the fetus grows. These muscles are less able to contract and keep the lower back in proper alignment. The pregnant woman has a different pattern of gait. The step lengthens as the pregnancy progresses, due to weight gain and changes in posture. On average, a woman's foot can grow by a half size or more during pregnancy. In addition, the increased body weight of pregnancy, fluid retention, and weight gain lowers the arches of the foot, further adding to the foot's length and width. The influences of increased hormones such as estrogen and relaxin initiate the remodeling of soft tissues, cartilage and ligaments. Certain skeletal joints such as the symphysis pubis and sacroiliac widen or have increased laxity.[citation needed]
Physical changes
One of the most noticeable alterations in pregnancy is the gain in weight. The enlarging uterus, the growing fetus, the placenta and liquor amnii, the acquisition of fat and water retention, all contribute to this increase in weight. The weight gain varies from person to person and can be anywhere from 5 pounds (2.3 kg) to over 100 pounds (45 kg). In America, the doctor-recommended weight gain range is 25 pounds (11 kg) to 35 pounds (16 kg), less if the woman is overweight, more (up to 40 pounds (18 kg)) if the woman is underweight.
Other physical changes during pregnancy include breasts increasing two cup sizes. Also areas of the body such as the forehead and cheeks (known as the 'mask of pregnancy') become darker due to the increase of melanin being produced.
Illustration of fundal height at various points during pregnancy
Cardiovascular changes
Blood volume increases by 40% in the first two trimesters. This is due to an increase in plasma volume through increased aldosterone. Progesterone may also interact with the aldosterone receptor, thus leading to increased levels. Red blood cell numbers increase due to increased erythropoietin levels.
Cardiac function is also modified, with increased heart rate and increased stroke volume. A decrease in vagal tone and increase in sympathetic tone is the cause. Blood volume increases act to increase stroke volume of the heart via Starling's law. After pregnancy the change in stroke volume is not reversed. Cardiac output rises from 4 to 7 liters in the 2nd trimester.
Blood pressure also fluctuates. In the first trimester it falls. Initially this is due to decreased sensitivity to angiotensin and vasodilation provoked by increased blood volume. Later, however, it is caused by decreased resistance to the growing uteroplacental bed.[citation needed]
Respiratory changes
The partial pressure of oxygen in arterial blood (PaO2) increases slightly and that of carbon dioxide (PaCO2) decreases during pregnancy. The resulting effects on blood pH are compensated for by increased excretion of bicarbonate via the urine, maintaining a normal acid-base balance.[41]
Progesterone may act centrally on chemoreceptors to reset the set point to a lower partial pressure of carbon dioxide. This maintains an increased respiration rate even at a decreased level of carbon dioxide.[41]
Decreased functional residual capacity is seen, typically falling from 1.7 to 1.35 litres,[citation needed] due to the compression of the diaphragm by the uterus. Tidal volume increases, from 0.45 to 0.65 litres,[citation needed] giving an increase in pulmonary ventilation. This is necessary to meet the increased oxygen requirement of the body, which reaches 50 mL/min, 20 mL of which goes to reproductive tissues. Overall, the net change in maximum breathing capacity is zero.[41]
Dyspnea (shortness of breath) is a symptom reported by the majority of women at some point during pregnancy. It typically begins during the first or second trimester, before chest volume is significantly restricted by growth of the uterus, so decreased lung capacity is not the primary cause. Possible factors include slightly decreased PaCO2 and the effects of progesterone on respiration, as well as the woman's subjective interpretation of increased respiratory rate in pregnancy.[41]
Metabolic changes
An increased requirement for nutrients is given by fetal growth and fat deposition. Changes are caused by steroid hormones, lactogen, and cortisol.
Maternal insulin resistance can lead to gestational diabetes. Increased liver metabolism is also seen, with increased gluconeogenesis to increase maternal glucose levels.[citation needed]
Renal changes
Renal plasma flow increases, as does aldosterone and erthropoietin production as discussed. The tubular maximum for glucose is reduced, which may precipitate gestational diabetes.[citation needed]
Pregnancy-5
Prenatal development and sonograph images
See also: Prenatal development
Prenatal development is divided into two primary biological stages. The first is the embryonic stage, which lasts for about two months. At this point, the fetal stage begins. At the beginning of the fetal stage, the risk of miscarriage decreases sharply, all major structures including hands, feet, head, brain, and other organs are present, and they continue to grow and develop. When the fetal stage commences, a fetus is typically about 30 mm (1.2 inches) in length, and the heart can be seen beating via sonograph; the fetus bends the head, and also makes general movements and startles that involve the whole body. Some fingerprint formation occurs from the beginning of the fetal stage.
Electrical brain activity is first detected between the 5th and 6th week of gestation, though this is still considered primitive neural activity rather than the beginning of conscious thought, something that develops much later in fetation. Synapses begin forming at 17 weeks, and at about week 28 begin multiply at a rapid pace which continues until 3–4 months after birth. It isn't until week 23 that the fetus can survive, albeit with major medical support, outside of the womb. It is not until then that the fetus possesses a sustainable human brain.
Embryo at 4 weeks after fertilization
Fetus at 8 weeks after fertilization
Fetus at 18 weeks after fertilization
Fetus at 38 weeks after fertilization
Relative size in 1st month (simplified illustration)
Relative size in 3rd month (simplified illustration)
Relative size in 5th month (simplified illustration)
Relative size in 9th month (simplified illustration)
One way to observe prenatal development is via ultrasound images. Modern 3D ultrasound images provide greater detail for prenatal diagnosis than the older 2D ultrasound technology.[37] While 3D is popular with parents desiring a prenatal photograph as a keepsake,[38] both 2D and 3D are discouraged by the FDA for non-medical use,[39] but there are no definitive studies linking ultrasound to any adverse medical effects.[40] The following 3D ultrasound images were taken at different stages of pregnancy:
75-mm fetus (about 14 weeks gestational age)
Fetus at 17 weeks
Fetus at 20 weeks
Some people are confused about the differences between an ultrasound and a sonogram. An ultrasound is the actual machine that lets you observe pregnancy. A sonogram is the image of the baby that the ultrasound produces. 4D Ultrasounds take 3D sonograms. Some people refer to the procedure as prenatal imaging, 3D imaging, a 3D scan, or 4D scan.
Pregnancy-4
Physiology
The term trimester redirects here. For the term trimester used in academic settings, see Academic term
Pregnancy is typically broken into three periods, or trimesters, each of about three months. While there are no hard and fast rules, these distinctions are useful in describing the changes that take place over time.
First trimester
Traditionally, doctors have measured pregnancy from a number of convenient points, including the day of last menstruation, ovulation, fertilization, implantation and chemical detection. In medicine, pregnancy is often defined as beginning when the developing embryo becomes implanted into the endometrial lining of a woman's uterus. In some cases where complications may have arisen, the fertilized egg might implant itself in the fallopian tubes or the cervix, causing an ectopic pregnancy. Most pregnant women do not have any specific signs or symptoms of implantation, although it is not uncommon to experience minimal bleeding at implantation. Some women will also experience cramping during their first trimester. This is usually of no concern unless there is spotting or bleeding as well. After implantation the uterine endometrium is called the decidua. The placenta, which is formed partly from the decidua and partly from outer layers of the embryo, is responsible for transport of nutrients and oxygen to, and removal of waste products from the fetus. The umbilical cord is the connecting cord from the embryo or fetus to the placenta.The developing embryo undergoes tremendous growth and changes during the process of fetal development.
Morning sickness occurs in about seventy percent of all pregnant women and typically improves after the first trimester.
In the first 12 weeks of pregnancy the nipples and areolas darken due to a temporary increase in hormones.
Most miscarriages occur during this period.[citation needed]
Second trimester
Months 4 through 6 of the pregnancy are called the second trimester. Most women feel more energized in this period, and begin to put on weight as the symptoms of morning sickness subside and eventually fade away.
In the 20th week the uterus, the muscular organ that holds the developing fetus, can expand up to 20 times its normal size during pregnancy. Although the fetus begins to move and takes a recognizable human shape during the first trimester, it is not until the second trimester that movement of the fetus, often referred to as "quickening", can be felt. This typically happens in the fourth month, more specifically in the 20th to 21st week, or by the 19th week if the woman has been pregnant before. However, it is not uncommon for some women not to feel the fetus move until much later. The placenta fully functions at this time and the fetus makes insulin and urinates. The reproductive organs distinguish the fetus as male or female.
Third trimester
Comparison of growth of the abdomen between 26 weeks and 40 weeks gestation.Final weight gain takes place, which is the most weight gain throughout the pregnancy. The fetus will be growing the most rapidly during this stage, gaining up to 28g per day. The woman's belly will transform in shape as the belly drops due to the fetus turning in a downward position ready for birth. During the second trimester, the woman's belly would have been very upright, whereas in the third trimester it will drop down quite low, and the woman will be able to lift her belly up and down. The fetus begins to move regularly, and is felt by the woman. Fetal movement can become quite strong and be disruptive to the woman. The woman's navel will sometimes become convex, "popping" out, due to her expanding abdomen. This period of her pregnancy can be uncomfortable, causing symptoms like weak bladder control and back-ache. Movement of the fetus becomes stronger and more frequent and via improved brain, eye, and muscle function the fetus is prepared for ex utero viability. The woman can feel the fetus "rolling" and it may cause pain or discomfort when it is near the woman's ribs and spine.
There is head engagement in the third trimester, that is, the fetal head descends into the pelvic cavity so that only a small part (or nothing) of it can be felt abdominally.
It is during this time that a baby born prematurely may survive. The use of modern medical intensive care technology has greatly increased the probability of premature babies surviving, and has pushed back the boundary of viability to much earlier dates than would be possible without assistance. In spite of these developments, premature birth remains a major threat to the fetus, and may result in ill-health in later life, even if the baby survives.
Pregnancy-3
Diagnosis
Main article: Obstetrics
The beginning of pregnancy may be detected in a number of different ways, either by a pregnant woman without medical testing, or by using medical tests with or without the assistance of a medical professional.
Most pregnant women experience a number of symptoms, which can signify pregnancy. The symptoms can include nausea and vomiting, excessive tiredness and fatigue, craving for certain foods not normally considered a favorite, and frequent urination particularly during the night.
A number of early medical signs are associated with pregnancy. These signs typically appear, if at all, within the first few weeks after conception. Although not all of these signs are universally present, nor are all of them diagnostic by themselves, taken together they make a presumptive diagnosis of pregnancy. These signs include the presence of human chorionic gonadotropin (hCG) in the blood and urine, missed menstrual period, implantation bleeding that occurs at implantation of the embryo in the uterus during the third or fourth week after last menstrual period, increased basal body temperature sustained for over 2 weeks after ovulation, Chadwick's sign (darkening of the cervix, vagina, and vulva), Goodell's sign (softening of the vaginal portion of the cervix), Hegar's sign (softening of the uterus isthmus), and pigmentation of linea alba - Linea nigra, (darkening of the skin in a midline of the abdomen, caused by hyperpigmentation resulting from hormonal changes, usually appearing around the middle of pregnancy).
Pregnancy detection can be accomplished using one or more of various pregnancy tests, which detect hormones generated by the newly formed placenta. Clinical blood and urine tests can detect pregnancy 12 days after implantation , which is as early as 6 to 8 days after fertilization. Blood pregnancy tests are more accurate than urine tests. Home pregnancy tests are personal urine tests, which normally cannot detect a pregnancy until at least 12 to 15 days after fertilization. Both clinical and home tests can only detect the state of pregnancy, and cannot detect the age of the embryo.
In the post-implantation phase, the blastocyst secretes a hormone named human chorionic gonadotropin, which in turn stimulates the corpus luteum in the woman's ovary to continue producing progesterone. This acts to maintain the lining of the uterus so that the embryo will continue to be nourished. The glands in the lining of the uterus will swell in response to the blastocyst, and capillaries will be stimulated to grow in that region. This allows the blastocyst to receive vital nutrients from the woman.
Despite all the signs, some women may not realize they are pregnant until they are quite far along in their pregnancy, in some cases not even until they begin labour. This can be caused by many factors, including irregular periods (quite common in teenagers), certain medications (not related to conceiving children), and obese women who disregard their weight gain. Others may be in denial of their situation.
An early sonograph can determine the age of the pregnancy fairly accurately. In practice, doctors typically express the age of a pregnancy (i.e., an "age" for an embryo) in terms of "menstrual date" based on the first day of a woman's last menstrual period, as the woman reports it. Unless a woman's recent sexual activity has been limited, she has been charting her cycles, or the conception is the result of some types of fertility treatment (such as IUI or IVF), the exact date of fertilization is unknown. Without symptoms such as morning sickness, often the only visible sign of a pregnancy is an interruption of the woman's normal monthly menstruation cycle, (i.e., a "late period"). Hence, the "menstrual date" is simply a common educated estimate for the age of a fetus, which is an average of 2 weeks later than the first day of the woman's last menstrual period. The term "conception date" may sometimes be used when that date is more certain, though even medical professionals can be imprecise with their use of the two distinct terms. The due date can be calculated by using Naegele's rule. The expected date of delivery may also be calculated from sonogram measurement of the fetus. This method is slightly more accurate than methods based on LMP. The beginning of labour, which is variously called confinement or childbed, begins on the day predicted by LMP 3.6% of the time and on the day predicted by sonography 4.3% of the time.
Diagnostic criteria are: Women who have menstrual cycles and are sexually active, a period delayed by a few days or weeks is suggestive of pregnancy; elevated B-hcG to around 100,000 mIU/mL by 10 weeks of gestation.
Pregnancy-2
Progression
Stages in prenatal development, with weeks and months numbered by gestation.
Initiation
Pregnancy occurs as the result of the female gamete or oocyte merging with the male gamete, spermatozoon, in a process referred to, in medicine, as "fertilization", or more commonly known as "conception". After the point of "fertilization", it is referred to as an egg. The fusion of male and female gametes usually occurs through the act of sexual intercourse, resulting in spontaneous pregnancy. However, the advent of artificial insemination and in vitro fertilisation have also made achieving pregnancy possible in cases where sexual intercourse does not result in fertilization (e.g., through choice or male/female infertility).
Perinatal period
Perinatal defines the period occurring "around the time of birth", specifically from 22 completed weeks (154 days) of gestation (the time when birth weight is normally 500 g) to 7 completed days after birth.
Legal regulations in different countries include gestation age beginning from 16 to 22 weeks (5 months) before birth.
Postnatal period
Main article: Postnatal
The postnatal period begins immediately after the birth of a child and then extends for about six weeks. During this period the mother's body returns to prepregnancy conditions as far as uterus size and hormone levels are concerned.
Duration
The expected date of delivery (EDD) is 40 weeks counting from the last menstrual period (LMP), and birth usually occurs between 37 and 42 weeks. The actual pregnancy duration is typically 38 weeks after conception. Though pregnancy begins at conception, it is more convenient to date from the first day of a woman's last menstrual period, or from the date of conception if known. Starting from one of these dates, the expected date of delivery can be calculated. Forty weeks is 9 months and 6 days, which forms the basis of Naegele's rule for estimating date of delivery. More accurate and sophisticated algorithms take into account other variables, such as whether this is the first or subsequent child (i.e., pregnant woman is a primip or a multip, respectively), ethnicity, parental age, length of menstrual cycle, and menstrual regularity.
Pregnancy is considered "at term" when gestation attains 37 complete weeks but is less than 42 (between 259 and 294 days since LMP). Events before completion of 37 weeks (259 days) are considered preterm; from week 42 (294 days) events are considered postterm. When a pregnancy exceeds 42 weeks (294 days), the risk of complications for woman and fetus increases significantly. As such, obstetricians usually prefer to induce labour, in an uncomplicated pregnancy, at some stage between 41 and 42 weeks.
Recent medical literature prefers the terminology preterm and postterm to premature and postmature. Preterm and postterm are unambiguously defined as above, whereas premature and postmature have historical meaning and relate more to the infant's size and state of development rather than to the stage of pregnancy.
Fewer than 5% of births occur on the due date; 50% of births are within a week of the due date, and almost 90% within 2 weeks. It is much more useful, therefore, to consider a range of due dates, rather than one specific day, with some online due date calculators providing this information.
Accurate dating of pregnancy is important, because it is used in calculating the results of various prenatal tests (for example, in the triple test). A decision may be made to induce labour if a fetus is perceived to be overdue. Furthermore, if LMP and ultrasound dating predict different respective due dates, with the latter being later, this might signify slowed fetal growth and therefore require closer review.
The Age of Viability has been receding relentlessly as medical revolution continues to unfold. Whereas it used to be 28 weeks, it has been brought back to as early as 23, or even 22 weeks in some countries. Unfortunately, there has been a profound increase in morbidity and mortality associated with the increased survival to the extent it has led some to question the ethics and morality of resuscitating at the edge of viability.[citation needed]
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