Notes From Ivanna

What are the most common childhood food allergies?

2010-03-01T21:17:23Z

According to multiple sources including the American Academy of Pediatrics and several medical publications and books including “Healthy Child, Whole Child”, a nationally renown book co-written by one of our guest interviewees, Dr. Russ Greenfield, “Food allergies in children under five are rapidly increasing as are the number of children with multiple food allergies. Peanut allergies alone have doubled between 1997 and 2002. And in a recent study outlined by Health Day News, the number of children with food allergies has gone up 18 percent and the number seeking treatment for food allergy at emergency departments or hospitals has tripled since 1993. Read the article here for more details.

As a mom of three little ones (all under four) I find it alarming how many children I come across that have some sort of food allergy. And while there are many theories as to why food allergies are growing exponentially, the best thing we can do as moms is to understand the most common foods that cause them and be educated on the symptoms and warning signs so we can ask our pediatrician the right questions and avoid a dangerous and even life threatening situation with our little ones.

According to the book, parents often confuse true food allergies with food sensitivities and food intolerances so I thought it may be useful to define each one below so you can ask your doctor how to differentiate between them and what signs to look out for:

Food Allergy: Causes a significant immune response or reaction. The child’s defense system sees part of the food’s chemistry as a foreign invader of the system and reacts to it as if it were an attack creating symptoms such as nausea, bloating, diarrhea, vomiting, wheezing, flushing, skin rashes and may even lead to fatal anaphylaxis. Food allergies tend to be most common in the first 2 years of life and can sometimes be outgrown. The most common foods that cause allergies are cow’s milk, wheat, eggs, nuts, corn, shellfish, and soy products. Children can also be allergic to additives commonly found in prepared food such as Monosodium Glutamate (MSG), tartrazine (FD&C Yellow No.5), benzoic acid, and sulfites. If you suspect your child has a food allergy, your pediatrician can order a skin or blood test (RAST) to determine with substances your child is allergic to.

Food Sensitivities: While these are considered real and problematic, they are not true allergies. In this case, your baby or child may not feel right (complaining of stomach ache or feeling over tired or heavy) after eating certain foods. Although these can cause some of the same symptoms as allergies, the way the immune system responds is very difference in that the reactions may be delayed 12-48 hours which makes diagnosing more challenging. The most common foods that cause such sensitivities are milk, wheat, corn, aged cheese and food additives and the symptoms can include digestive issues, joint pain, rash, severe case of cradle crap, fatigue, nasal congestion, recurrent respiratory tract infections or breathing problems. Some experts even think that food sensitivities contribute to recurring ear infections, headaches, and even ADHD.

Food Intolerances: These are not an immune problem but more of a digestive issue that comes about when a baby or child is deficient in the required enzyme to decompose a particular type of food in the intestines. A very common example is lactose intolerance which is when there is a lack of the enzyme lactase that breaks down milk sugar. The most common foods that cause these are: dairy food, wheat, and the sweeteners fructose and sorbitol. Children with intolerances can continue eating these foods if they supplement with the required enzyme or eat them in smaller amounts less often.

Source: Healthy Child, Whole Child (pages 265-266).

The American Academy of Pediatrics has a good set of educational materials for parents who want to understand if their child has an allergy in a section called “How Do I Know If My Child Has a Food Allergy”?. Definitely check it out when you get a chance and ask your pediatrician about ways to be able to quickly tell if it’s indeed a food allergy, sensitivity or intolerance. An example of a food allergy’s repercussions is Celiac Disease which has also been increasing dramatically among children under five in the Unites States. In the case of Celiac Disease, which causes malabsorption (a failure of the bowels to absorb nutrients). It’s caused by an immune reaction to gluten (the protein found in wheat, rye, barley, and, in some cases, oat products) that takes place in the intestine and stimulates the body’s immune system to attack and damage the lining of the intestine, preventing nutrients from being absorbed into the system. Unlike other allergies that may be outgrown, if your child does have celiac disease, she must remain on a gluten-free diet for her entire life, completely avoiding wheat, rye, barley, and, in some cases, oat products.

Best we can do as moms is to be informed and educated on these allergies and have good conversations with our doctors about it. If your child does indeed develop an allergy that requires treatment be sure to ask about all the factors that you need to consider such as symptoms and side-effects, treatment dosage, nutrition implications, etc. Read Expert Blogger, Dr Sheila Kilbane, MD’s post answering a mom’s question about cow’s milk allergy here.

What is Integrative Medicine?

2010-01-03T21:45:25Z

I recently had the pleasure of meeting a local board certified pediatrician (Dr Sheila Kilbane, MD) who introduced me to the medical philosophy of “integrative medicine” as she prepared to expand her practice. I honestly had not heard of this concept before. I had heard the term “western medicine”, “traditional medicine” versus “holistic medicine”. And my experience had been that most practitioners were on opposite sides. MDs frowned upon discussion of alternative disease prevention and treatment options and dismissed them as not “real medicine” and “medical school dropouts”. And at the other end of the spectrum, naturopathic doctors had become somewhat skeptical of modern medicine because they believed it focused solely on aggressive and highly invasive disease treatment methods rather than prevention and looking at patients as more than just the sum of their body parts.

So when she described to me the notion of finding common ground and integrating the best of conventional/modern medicine and research-based science with alternative medicine so we can better take care of ourselves and more importantly, our children I was fascinated. So fascinated that after attending a dinner presentation she and her practice partner presented at, I took it upon myself to read more about it. I found many articles on it from reputable sources including WebMD and Duke Integrative Medicine at Duke University (if you click on these links you will be taken to these articles) and I researched more about its founder, Dr Andrew Weil, a Harvard medical school educated physician who founded and serves as Program Director of the Arizona Center for Integrative Medicine.

In addition, I stumbled upon a book called “Healthy Child, Whole Child” and I have been forever changed. In the first chapter of the book the key principles of the integrative medicine philosophy are described. The author notes that some MDs already practice this without labeling it as such, but the majority don’t because it’s not highly focused on in medical school. What drew me to it is the middle ground, the compromise and the ability to be open minded about different alternatives. So here they are:

The Whole Person – body, mind, spirit, lifestyle, nutrition, environment is taken into account
Treatment focuses on the underlying causes of a health problem as well as the symptoms
The body’s natural capacity for healing is engaged and supported
Doctor and patient work in partnership
Care is individualized and tailored to each patient’s unique medical history, conditions and profile
Both conventional and “alternative” therapies (such as meditation, acupuncture, stress/relaxation techniques, herbal supplements, etc) are considered and not mutually exclusive
Emphasis is placed on prevention of medical problems and promotion of healthy behaviors including the acknowledgement that patients and parents have good instincts about their health.
Gentler therapies with fewer side effects are tried first and then if those don’t work, more intense, invasive options are applied.

Source: “Healthy Child, Whole Child” – Ditchek (MD) and Greenfield (MD) 2009

What I like about this approach is that the foundation is solid research and modern medicine, but at the same time, it is coupled with the acceptance that sometimes other options are available before we jump on aggressive medicines and or surgery. So let’s take for example something as common as an ear infection. If your pediatrician practices integrative medicine, they would partner with you and explain to you that in many cases (as high as 90% of cases) ear infections go away on their own and so a “wait and see” approach may be prudent especially if the child does not have a high fever or is exhibiting any serious symptoms, rather than automatically prescribing an antibiotic. As we all know, the current over-prescription of antibiotics is causing many resistant bacteria to flourish (such as MSRA).

So how do you tell if your pediatrician is currently practicing this approach and if he/she is not, what can you do as a parent? Below are some great tips that I read on the book and started practicing with my own doctor.

1. Keep your own medical file for each family member (record of doctors visits, vaccines, prior conditions, test results, medications taken, side effects, allergic reactions, etc)

2. Write down the questions you want to ask your doctor (prior to your appointment and then hand them over to doctor at beginning of appointment)

3. Don’t be afraid to talk to your doctor

4. Be honest about all nontraditional approaches that have been tried and whether they worked for your child

5. If a drug is prescribed, as if it is needed right away (ask about side effects and if a “wait and see approach” is prudent

6. Ask for handouts or other printed materials available on subjects of interest to you

7. Educate yourself

So next time you visit your pediatrician or family doctor, if you are interested in this philosophy of medicine, ask them what they think. You might just be surprised.They may even welcome your more involved and active role as a parent and as a patient. And if you’re committed to exploring this approach and he/she is not open to it, you may want to look into other doctors who are. Please welcome Dr. Kilbane to our empowered mommies community! and be sure to read her latest blog here on our site. She expands upon what it means to practice this medicine philosophy with children.

Remembering What’s Important

2009-12-11T20:34:27Z

Many of us have a hard time finding balance during the holiday season. It seems as if for some of us Thanksgiving begins a grueling marathon that won’t end until after the New Year and if you celebrate other related events like Boxing Day or Dias de Los Reyes can extend into the first week of January. Some people view the holidays as a time that needs to be survived and lived through. And when adults feel that way, our children, especially the little ones, can absorb this energy become over-stimulated, uncomfortable or even frightened. New faces, new places and social gatherings can quickly fill up your calendar and you may find yourself driving to and fro to accommodate invitations from friends and family or you may be hosting and get stressed over that. So to all this, I say….take charge! :) Easier said than done, I know.

But let’s take a breather. Relax and remember what’s important. Below are some of the things I try to keep mind and live by as the holiday season comes around, especially now that I am a mom of 3 small children. I’m still learning as I go, but I hope some of these can remind you of what to keep in mind as December comes into full swing. Please feel free to leave comments and share your tips too in our forums and message boards. I decided it’d be neat to rate some of these with our Empowered Mommy Ratings so check them out!

Spend Time With People You Really Want To: The Holiday Season is replete with social events and obligations. And some without a doubt (like work-related functions) you will need to attend even if you don’t feel like it. But for the rest of them, make sure you spend your energy and time on people you truly want to be around with! You’re an adult, a mother, and you shouldn’t have to attend events out of guilt or “obligation”. I certainly wouldn’t want people seeing me because they felt obliged. Especially when it involves our children. Focus on the people that mean the most to you and really stop and ask yourself, “Do I need to get involved with this? and how will affect my babies or toddlers?

Obsessing About Details: If you’re the host of an event, don’t get caught up in minute details. Yes, we all want to hold a great event but keep everything in check and prioritize. Most likely your guests won’t notice the little things and if they do (they’re not the type of people you want to invite again anyways). When you have young children, some things have to take a back-seat and that is ok!

Don’t Be Afraid to Ask For Help: We all need help once in a while. This is even more true if you’re a new mom or have young children. So don’t be afraid to ask friends and family for help during the holiday season. Need help with cooking? Someone to take care of the kids while you go Christmas shopping?

Setting Unrealistic Expectations: The meticulously decorated house, the perfectly trimmed tree, the family portrait greeting cards, the perfect holiday party, the spotless house, all the folded laundry, all beds, made, all carpets clean, etc…etc…etc…. While all of these sound great and maybe there are moms out there who are able to accomplish all this while taking care of infants, I am certainly not one of them. Striving for perfection is exhausting and in its very definition, perfection does not exist. So why waste our time and energy pursuing it? Instead set priorities. What is most important to you? Griswold-style lighting outside? A big tree? Attending holiday themed events with your kids? And if you choose to want to do it all, it’s okay if some things fall to the side.

Focus on Memories/Experiences and Not Things: This is my humble opinion of course, but I believe that you and your children will remember experiences and feelings about the holidays not things. Case in point, I don’t remember any of my gifts or the decorations my mom put up during my childhood holidays, but I do remember the events we attended, the holiday dinners and meals we cooked and the time we spent together as a family.

Comparing or Competing with Other Moms: I don’t have tolerance for this honestly. Every family is different. Different children, different situations, different parents, so why even bother comparing or competing with fellow moms? Certainly, our time as precious and scarce as it is can be focused elsewhere. Comparing for the sake of comparing can be human nature at times, but when it leads to resentment and envy can be quite poisonous and toxic to the mind, body and soul.

How Worried Should We Be About H1N1?

2009-11-03T03:59:53Z

Unless you’ve been under a rock since this past summer, you have probably been bombarded by constant information (at times conflicting) regarding the H1N1 influenza. What began as a public health issue in Mexico City, has now become the hot topic of the season across the world especially in the Northern Hemisphere as we enter the Fall and Winter months. So what is a concerned parent to do? And what if you’re pregnant? Should we be concerned about the vaccine and the fact that it has come to market without all the required FDA approvals? How do we balance the risk of not vaccinating (if we choose to do that) with the risk of developing complications from this strain of influenza? And if we do vaccinate, how do we remain vigilant for potential side effects? How do we remain calm, educated and empowered through the process without falling prey to misinformation and mass hysteria.

Without a doubt, I am on the same boat. While I have never had a seasonal flu shot (my eldest daughter did receive one during her first year of life and none since then), this new strain does raise some concern with me as a mom of three young infants. And so I began researching, reading, speaking with pediatricians, virologists, nurses, integrative medicine (holistic) doctors and anyone else who claimed to be an expert on the subject. As of now, there are limited quantities of H1N1 vaccines available, but are increasing on a daily basis. Both the Nasal Spray (live) and injections are available. What is interesting, and a little disconcerting, is that members of the medical community have opposing views as to whether or not you should rush to get vaccinated. So hearing this I decided to compile a list of the Pros and Cons on each side. You’ll find at the end that there is no crystal clear answer as to what to do. You should do what you feel most comfortable with. Just remember to ask questions, research, partner with your medical provider but also remain healthily skeptical. No one cares more about the health and well being of your babies than you do! And each person is different. As Empowered Mommies, we should gather as much unbiased, fact-based information as possible to make an educated choice for our families and ourselves.

CONS

Not enough information from the FDA. To early to start using it. Some doctors are even going as far as to tell their pharmacies not to recommend it yet. The reason behind most of those opposed? Production of the vaccine was started before the FDA had concluded their testing. All of this was done to be certain that the vaccine would be available on time to distribute to the public.
There is even a FDA statement associated with the vaccine that states that "Clinical Studies are Ongoing" according to some doctors this can only mean that all of the evidence is not yet in.
Skeptics are telling us that this untested vaccine is potentially dangerous and unnecessary. A version of this vaccine was administered in 1976 and caused Guillian Bar Syndrome (GBD). GBD is an autoimmune disorder which causes paralysis. The risk is about 1 in 1 million
H1N1 in 99% of cases turns out to be no different than the regular flu with no serious complications.
Some people have expressed concern about thimerosal for children because it has a mercury-base, but the CDC states there is no scientific evidence the preservative is harmful.

PROS

Immunize before it causes a major pandemic across the country.
They want to vaccinate as many people as possible as quickly as possible.
This was the only way they had to get the vaccine to the public in time for the flu season.
Some say that there "were no shortcuts" by the FDA inspectors.
Some doctors also tell us that even though the vaccine production was speeded up, the quality of the inspections were just as thorough.
The production of the normal seasonal flu vaccine and the H1N1 Swine Flu vaccine differ very slightly.
It should be given to the public ASAP because children especially are at a higher risk for the H1N1 Swine Flu virus.
Serious complications can include pneumonia, breathing complications and even death in a small number of cases. ** Note: One common theme among child deaths has been an underlying bacterial infection right after the flu which has allowed certain forms of bacteria to enter the upper respiratory system and lungs (that had been weakened by the flu virus).

On Postpartum Care

2009-10-04T03:41:18Z

While it’s true that your newborn demands a lot of attention and tender loving care during the first few weeks after birth, you need to take care of yourself too. Wow! Is it me? Really, giving “this” advice? As a novice mom, I lost track of that amidst late night feedings, lack of sleep and the overall overwhelming feeling of taking care of a new life. With each experience, regardless of how many children I had already, this notion of remembering to take care of myself would quickly dissipate among the many to-dos that come with taking care of a new baby, other children, a household etc. But it finally hit me at around 2 weeks post-partum especially with my third child, that it’s really important to seek help when necessary and understand all the changes that take place between birth and the first post-partum check up at 6 weeks. After all, it’s not just your physical well being, but also your psychological and emotional recovery that is as equally important.

So, what is my best tip? Go back to basics. Throw away all your to-do lists and just focus on you and the baby! Try to forget about the piling laundry, cooking, and other chores. Don’t feel guilty about staying in your PJs for a large part of the day or asking for help or ordering food or accepting prepared dishes from friends and family during this critical post-partum time period. If you’re lucky enough to have family come stay with you (like I had with my mom who was here with all 3 of my births) then definitely take advantage of that! The way I can best organize my thoughts on post-partum care is by recollecting that critical 6 week period week by week and what I remember happening at each stage. Interestingly enough with all my 3 kids, I had similar post-partum experiences. Here is my recap. Hope it helps!

WEEKS 1 and 2

What I experienced:

Period like pains called “uterine contractions”
Continued bleeding even passing small blood clots. Bleeding went from bright red at the beginning to brownish discharge towards the end of week 2
*** engorgement especially if your *** milk is coming in already. With my 3rd child I developed a case of “mastitis” which can become serious if left untreated. (see symptoms of that below).
Episiotomy pain (with my first). * If you had a c-section you may have pain in the abdomen incision site)
The embarrassing and annoying hemorrhoids due to all the pushing and some constipation

Things I did that helped:

Took ibuprofen for the uterine cramps. You can also try warm showers and massages to alleviate the pain.
Nursed as frequently as possible to avoid the *** engorgement and applied warm compresses to the breasts to help with milk letdown. I also consulted a Lactation Consultant because I was experiencing some pain towards the end of Week 2.
Took sitz baths to treat the area down there and used hemorrhoids wipes and cream to sooth the bottom.
Drank lots of water and ate fruits and vegetables to avoid constipation.

WEEKS 3 and 4

What I experienced:

Tiredness, grumpiness and yes, I said it, moodiness * (Please check out our Forum on the difference between hormonal fluctuations/baby blues and what some new moms experience which is full blown PPD).
Sleep-deprivation
Continued soreness in breasts and vaginal region

Things I did that helped:

Tried to sleep when I could. With my first, I had my mom stay with us and she did “baby night duty” every once in a while and that was great because it allowed me to catch up on sleep. I also enlisted the help of my husband to help with feedings (through expressed, pumped *** milk bottles)
Got out of the house to go for walks and see the outside world. Did wonders :)
Practiced breathing exercises and visualization to relax and stay positive
Stretching and back exercises especially for my lower back

WEEKS 5 and 6

What I experienced:

Even though I was starting to heal physically from birth, I felt strange about my body. Big boobs, poochy belly and tired
Incontinence! (yes, I admit…a laugh or the wrong exercise would make me pee my pants).
Sleep-deprived (this continues beyond the 6 weeks post-partum I might add ;)
Continuing hemorrhoids

Things I did that helped:

Started working out gently but more often and did more stretching and back exercises
Kegels, Kegels, Kegels! (so important not only for your potential incontinence, but also for your sexual recovery)
Napping where possible
Continued sitz baths

IMPORTANT: There are some serious signs that need to be taken very seriously and immediately reported to your doctor if they happen during this period. Don’t wait until the 6 week post-partum check up to tell your doctor about these!

Unexplained swelling in any of your extremities
Fever
Severe vomiting
Deep chest pains
Vaginal bleeding that gets worse and worse
Foul-smelling discharge from your vagina or C-section incision
Hot or red breasts (especially if you have a fever or accompanying chills). This can be a sign of mastitis. A bacterial infection of the *** that needs to be treated with antibiotics to avoid complications.
Extreme sadness, depression or thoughts of harming you or your baby

Why I’m Pro-Vaccines, Yet Cautious In My Approach

2009-08-07T02:45:00Z

Let me begin by saying that I am very much pro-vaccines! I am a big believer in their benefits for preventing life-threatening diseases and eradicating others altogether. If it weren’t for vaccines, we’d still have children dying of diseases like polio. I personally don’t agree with some parents’ decision not to vaccinate their children at all because that seems too extreme to me. But on the other hand, I have read enough, spoken with pediatricians, and personally experienced some scary side effects ( ie: a febrile seizure with one of my children) to know that a cocktail of 5-6 shots at once may be too much for some infants’ maturing immune systems. As a parent, especially a first time parent, the latest controversy and news regarding vaccines in particular the MMR (Measles Mumps Rubella) shot and some people’s belief that it contributes to autism, can make immunizations a stressful time. What do you do?

I, being a moderate in much of my thinking regarding my kids’ health, believe in compromise and education. Where we understand potential risks and benefits, yet can take the best of both worlds and do the right thing as parents and as member of society as a whole.

So for those parents, like me, that want to make sure their babies have all the necessary vaccines to protect them and society, yet want to feel that they are controlling the timing and spacing out shots to prevent potential side effects, you may want to consider Dr Sear's alternate vaccine schedule. It’s very doable and realistic. It may add a couple of extra pediatrician visits in between months but that to me is worth it. Be sure to go over it with your pediatrician to make sure he/she is okay with your decision to have this spaced out schedule. It is so important to have a close relationship with your baby's pediatrician. After all, this is a person who has gone to school for 10 + years to become educated on our children's health and they do have our children's best interest at heart. Otherwise they would have chosen another profession! :) Just be honest and respectful and explain your fears to them. Communication is key. You'd be amazed how accommodating and understanding many pediatrians are today as many are parents themselves! They shouldn't be too concerned if you decide to do an alternate schedule as long as ultimately your child gets all the required shots by the time they enter school and you understand the risks associated with an alternative schedule.

In addition, I can't emphasize enough how important it is, especially for time parents, to monitor for side effects including allergic reactions to vaccine ingredients and fever. As I learned, a quickly spiking fever can cause a seizure with your child. While these are considered benign by most doctors, they are extremely frightening for parents to witness (believe me, I know).

I am adding this section to my original blog entry above today (Thursday Sept 3) because it illustrates a point. Two weeks ago my son received his MMR and there has been no reaction whatsoever to it (not even a mild fever!) so there you go....side effects can occur or not and it's different with each child. Best advice I can give is for you to be educated and work in a trusting and mutually respectful partnership with your medical provider when it comes to vaccines. And don't be afraid to ask questions. Tons of questions if you're nervous or scared!

Link to American Academy of Pediatrics Standard Schedule

http://www.cispimmunize.org/IZSchedule_Childhood.pdf

Dr Sear's Alternative Schedule (Below)

Age	Recommended Vaccine(s)
2 months	Dtap and Rotavirus
3 months	Pc and Hib
4 months	Dtap #2 and Rotavirus #2
5 months	Pc#2 and Hib # 2
6 months	Dtap # 3 and Rotavirus #3
7 months	Pc#3 and Hib #3
9 months	Polio #1 and Flu * (2 doses)
12 months	Mumps and Polio #2
15 months	Pc #4 and Hib #4
18 months	Dtap #4 and Chickenpox (varicella)
21 months	Flu
2 years	Rubella and Polio #2
2 years and 6 months	Hep A and Hep B
3 years	Hep B # 2, Measles and Flu
3 years and 6 months	Hep A #2 and Hep B # 3
4 years	Dtap #5, Polio #3 and Flu
5 years	MMR, Flu
6 years	Chicken Pox # 2 (varicella)
12 years	Tdap and HPV (for girls)
12 years and 2 months	HPV #2 (for girls)
13 years	HPV #3 (for girls) and Meningococcal

Lessons on Bringing A Newborn Home

2009-07-07T15:55:00Z

Wow, where to start! I wish I could say that by the time I brought my third child home a little less than 3 months ago, I finally knew what I was doing having gone through it twice before, but alas, new surprises and things popped up that threw me for a loop. Just like every pregnancy and labor/delivery experience is different so is the arrival of your new little bundle of joy into your home. New challenges emerge as you try to fold this new life into the rest of the family structure with its routines, other siblings, etc. But amidst the different things that come up, there are some basic fears that many new moms feel when they first bring their newborn home (at least, these were the fears that I had). I’ll let you know how I dealt with them and what I learned and what I continue to learn everyday.

I don’t know anything about baby care

Even though I grew up the eldest of six children and helped my mom around the house and in caring for my younger siblings, the last time I had taken care of a baby had been nearly 20 years earlier with my youngest brother so much about baby care was unknown to me. First thing I did was ask my mom for advice (after all, the woman did raise 6 children). She came to stay with us for a month after my first child’s arrival and I turned to her with general questions. In addition, I sought advice from my pediatrician to get the latest news while also seeking the informal advice from other moms. You may be fortunate enough to have additional sources of advice and help like a postpartum doula or midwife or a certified newborn specialist. Ask questions if you have the opportunity!

Most importantly, I read, read, read. Doing research and being informed is something I am very passionate about (just in case you hadn’t noticed…wink wink). I think the more informed you are as a parent and a patient, the better you can partner with your healthcare providers and make wiser decisions for you and your family. You’re able to ask the right questions during the pediatrician visits, discuss something recent you read in an article, etc. It makes you an active patient/parent and not a passive one. This doesn’t mean that you have to go out and buy a dozen books on baby care, but rather go to your local library and pick up 1 or 2. A good book for example is the American Academy of Pediatrics “Caring For Your Baby and Young Child”. I am also a fan of Dr Spock Series.

My baby could become a victim to SIDS

SIDS is a scary thing without a doubt not only for new parents but for all parents every time they bring a newborn home no matter how many times you’ve gone through it before. The important thing is to understand what factors increase the likelihood of SIDS. Ask your pediatrician. You can also find great information at this link. http://sids-network.org/risk.htm

If you reduce the factors, you can lower the chances of this affecting your baby. Otherwise you’ll find yourself checking on him/her every 30 minutes like I did with my first baby (putting my makeup compactor glass to her mouth to check her breath). Now I know the factors! Duh!

I won’t be able to breastfeed

Every new mom worries about this. What if I can’t breastfeed? What if I don’t produce enough milk, etc. The important thing is to remember that unless you have a fundamental medical issue that prevents you from breastfeeding, you’ll learn to do so with patience and care. It won’t be automatic and it will take effort but with the help from a lactation consultant, baby nurse or post partum doula, you can be guided into effective techniques for *** feeding your baby. Whatever you do, don’t be bullied or pushed into feeding your baby formula at the hospital if you don’t want to! The baby needs only a little bit of colostrum during your hospital stay and it’s normal for he/she to lose some ounces at discharge relative to his/her birth weight. Believe me. I know. I learned my lesson on that one with my first child and I did not make the same mistake again with my other two kids. If you’re worried about having enough milk supply or resting and having someone else feed your baby, then rent a hospital grade pump and use it.

My baby will cry and I won’t be able to console him/her

Every new mom’s nightmare is a baby that cries and cries despite your best efforts to comfort him/her. Here it’s important to understand the signs of colic versus other things that may be making the baby cry like a dirty diaper or hunger. Our Certified Newborn Specialist Blogger Nancy did a really good job describing colic and ways to reduce it and prevent it. Check out her blog on that topic. Invariably there will be times where the baby cries non-stop but rest assured that your smell and sight will calm her down in most cases.

My baby isn’t normal

I know realize that every child develops differently and at different speeds. But when I brought my first baby home I was obsessed with her reaching certain developmental milestones “in time” (whatever that means). Rest assured that this paranoia is normal and so is your baby! Take those milestone charts at the doctor’s office with a grain of salt as there may be some variation. At each scheduled wellness visit the pediatrician will ask you questions and observe the baby to make sure they are doing “normal” things for their age. However if you do notice something different, a change in their behavior, trust your guts and share those with your doctor. I am a believer that a mom’s instinct goes along way in bringing to light issues that our babies may have.

Of course, I had more fears. Deeper ones that don’t necessarily have a clean answer or book where you can look them up. Perhaps the biggest ones of all were and continue to be the fear of anything happening to my children and me being a bad mother. Hmmm….not sure those ever go away. At least not for me.

4 Most Common Labor/Delivery Scenarios and Questions to Ask Your Obgyn

2009-06-16T15:32:00Z

After hearing stories from fellow moms, doing research and in my own personal experience, I've come to realize that expectant moms need to demand that there is an honest and open discussion of all reasonable alternatives with pros and cons for common scenarios that tend to come up as we prepare for labor and delivery. We can no longer accept: “the baby is too big, we need to induce, do a c-section” etc. The ultimate decision regarding care should rest with both the mom and doctor in an equal partnership.

Assuming you have no pre-existing medical conditions or issues (such as diabetes, preeclampsia, placenta previa, etc) here are some common scenarios you may encounter as you prepare to give birth and below are some important questions you should feel empowered to ask your doctor so that no matter what ends up happening (even if it wasn’t part of your plan) you’ll feel that you understood all your options and made the best decision for you and your baby.

Scenario 1: You are “overdue” getting close to 41 weeks. Your doctor advises that you must induce or your baby will be “too big” and could be harmed.

• What’s the absolute latest date I can avoid induction?
• What are the realistic risks if I wait versus risks of induction?
• Couldn’t my due date be off by 2 weeks?
• Are there natural ways to encourage the onset of labor (diet, exercise, etc)?

Scenario 2: You’re told that your baby is breech. Your obgyn tells you the baby must be delivered via cesarean due to the high mortality risk

• Can you attempt an external cephalic version (ECV) to try to correct any sort of mal-presentation (be it breech, transverse, etc) before considering the scheduling of a C-Section prior to due date?
• What’s the absolute last date I can wait to see if baby corrects itself in its presentation?
• What are risks of C-section?

Scenario 3: You’ve had a previous C-section and would like to try for a VBAC.

• Do you support VBACs and does the hospital?
• If not, why not?
• Risks of VBAC versus surgery?

Scenario 4: You are told you have narrow hips and vaginal delivery may not be doable.

• Why do you perform pelvimetry? (many obgyns don’t since there is more to the the pelvis than the apparent visual aspects of size and shape)
• Can you describe the 4 Ps of labor assessment given the size of my pelvis?
• I'd like to still attempt a vaginal delivery and then determine if c-section may be necessary. What would you look for in that situation?

FURTHER READING

http://www.parents.com/pregnancy/labor-delivery/basics/the-truth-about-due-dates/
http://www.lamaze.org/AskHenci/tabid/363/forumid/12/postid/31528/view/topic/Default.aspx
http://www.lamaze.org/Research/WhenResearchisFlawed/VBACLieberman/tabid/176/Default.aspx
http://parenting.ivillage.com/pregnancy/plabor/0,,midwife_4648,00.html

The Myth of the EDD: Why Your Due Date May Not Be When You Think

2009-06-14T05:03:00Z

My first child was 2 weeks "early", my second was supposedly 1 day "overdue" and my third was nearly a week and a half "overdue" to the point that I would have been induced had I not gone into labor that weekend (my inducement would have occurred that following Monday for fear of baby getting too big, umbilical cord wrapping, etc). So prior to that cut off date, I politely insisted to my doctor that unless there was a medical need or signs that my baby was under duress, I did not want to be induced and preferred to go into labor naturally. And in hindsight, I am glad I did because my baby did arrive safely on her own time. But future moms out there, especially first time moms...rest assured that the estimated due date (EDD) is not necessarily when you think. It is an estimate at best based on length of cycle and first day of last period. The wrench is the calculation is usually the length of cycle that can range from 28-35+ days for some women. So in reality, there is possibly a window of nearly 7 days or more by which your due date can be off. Below is a wonderful article regarding this very subject that makes many expectant moms antsy. http://www.associatedcontent.com/article/1047180/the_lie_of_the_edd_why_your_due_date.html?cat=25

So if you're approaching your due date, take a deep breath, talk with your doctor/midwife and understand all your options before you rush into anything! :)

Three Babies, Three Very Different Labor/Deliveries

2009-06-01T05:27:00Z

After giving birth to my third child this past April, I am now convinced just how different each pregnancy is especially each onset of labor.

My daughter arrived in her strong spirited way more than 2 weeks before her due date and a day before her baby shower. She made a grand entrance after nearly 20 hours of laboring at home and at the hospital. It was truly exhausting, but I am very happy I decided to labor in the comfort of my home for as long as I could. We only headed to the hospital once the contractions started kicking into high gear.

It was a Friday morning and I sensed something different as I showered. I had a doctor's appointment that same morning and I remember him saying that my water had not broken yet but that perhaps he would see me later on that day. I went home and continued with some minor discomfort until the afternoon when active labor began. I still remember my sisters and mom taking notes of the timing of my contractions on a small whiteboard on my fridge while my husband comforted me. "So, you think I should cancel the baby shower?" I naively asked in between contractions. My mom smiled with wisdom as if anticipating what would come and how I wasn't yet aware of what lay ahead.

Once we got to the hospital, the contractions continued and I decided to have an epidural in order to get some sleep before the final push. While I welcomed the pain relief, the epidural itself numbed me to the point that I couldn't feel the urge to push naturally. I received directed pushing instructions from my nurse and doctor which helped, but I still felt restricted. In the end after about 45 minutes of pushing, my little girl emerged. I had to have an episiotomy to hasten her head's emergence. But I always wondered if I had been able to feel the urge to push, could that have been avoided.

My son on the other hand, was gentle and soft and honestly I did not feel I was in active labor until a few hours before pushing time when my water broke. We had decided to head out to the hospital in the wee hours of the morning (a day after his official due date) because I had been bleeding a little bit and having soft contractions. So to be on the safe side, we opted to be in the hospital this time for most of the laboring. I remember sitting on my hospital bed watching movies to pass the time and being told by the nurse reading my fetal monitor that I was having a "good" contractions. I couldn't believe it! These contractions were a piece of cake in comparison to the discomfort I had felt with my first baby.

About 12 hours later, he arrived. His labor was beautiful and I managed to get through it without an epidural. I felt the urge to push naturally and that made the pushing phase faster and easier. It felt so amazing to feel everything to the very core! Quite the fait accompli :) And even though it was painful at the very end, I swear it was not as bad I thought it would be. In my head I had made it worse than it really was. I think fear of pain keeps many of us from even trying to reduce unnecessary interventions during labor and delivery. But after going through this experience my confidence and trust in my body surged. It felt so good! Your body does know how to deal with the pain because it is pain with a purpose: a wonderful thing, really!

As if that experience hadn't been a complete 360 from my first baby, this third child threw me for a complete loop. About a week overdue, I was starting to consider the option of getting induced but I had asked my doctor for the latest, latest date to do this because I wanted to avoid inducement if possible. So what started as a Friday date night with my husband ended in the labor/delivery room in a matter of hours!

While my parents watched our other kids for the evening, we had finished having dinner. I joked with the waiter that I wanted the spiciest dish they had for obvious reasons and he nervously smiled as he placed my order. "Really?, it could happen right now?" he said. You could tell he was young and not a dad yet. Poor thing...

We then headed over to the theater to catch the last showing of Duplicity. (I don't care what critics say, I think the movie was entertaining and personally thought Julia Roberts looked great in a more mature role). By the time we got out of the movie it was around midnight.

Sensing something "different", call it woman's intuition or what have you, I settled into bed while my mind raced. I closed my eyes and about 2 hours later, I knew it was happening. "This is it, sweetie". "I think we're having this baby tonight". And then Boom! It hit me like a ton of bricks. I went from feeling almost nothing to experiencing hard labor contractions that were barely 2-3 minutes apart. No recoup or downtime in between!

I then realized that this would be an entirely different experience. No time to labor at home for hours like I had done with my first child and definitely no gentle and calm onset of labor while I watched movies like I had experienced with my son. No Nooo.... this little girl's arrival was going to be intense. Sensing this, I told my husband that it would be best to head to be hospital right away.

As we entered the hospital's triage area, I was greeted by the very nice nurses there. I was checked out and confirmed that I was already 5-6 cm dilated and this little girl was ready to make her appearance real soon.

In a moment of serendipity, I recognized one of the nurses. She had been the same one to help me deliver my first child. I am not good with names necessarily, but I am with faces and this was definitely her. She had been wonderful back then and I mentioned it to her and she smiled. This sweet surprise helped me overcome the fact that my Obgyn was traveling out of town this weekend. The Ying-Yang of life I guess….

By the time I was checked in and in my labor room it was close to 4am. My contractions had not eased up and I swear this was perhaps the most painful of all my deliveries. Like with my second, I had committed to a natural birth and now there was no looking back.

Before I knew it, I felt the intense pressure to push. I remember the nurse saying "hold it for a bit, the doctor (my obgyn's partner on call) is on his way. "No, you don't understand! I can't stop…this baby is coming out NOW!". And so it happened, her head and shoulders were out by the time the doctor made his way in. Everything else happened in a flash. To think 6 hours ago I had been enjoying some late night popcorn at the movies and now there I had become the mother of 3!!

Moral of my stories? Each baby is different, but the confidence, rush and exhiliration I felt trusting my body and its abilities is uncomparable to anything else I have ever experienced. I've been forever changed.

Mommy Bloggers Wanted

2009-05-26T21:19:00Z

Calling All Moms Interested in Being A Featured Blogger On Our Site

Are you a first time mom? Are you expecting or trying to conceive? Do you have an interesting and positive birth story to share or just good overall mommy advice?

Then you may be who we’re looking for to become a featured blogger on our site. I know how busy you all are so we would only require 1 blog entry (1-2 paragraphs) per week. If you think you’d be interested, please complete the below few questions and email me at Ivanna@empoweredmommies.com. We’re hoping to have four mom bloggers with each focusing on a different stage: TTC, Pregnant, Mom of Newborn, Mom of Infant (under 2).

1. Name

2. Stage (ie: trying to conceive, pregnant, mom of newborn, mom of infant, etc)

3. What you would like to Blog About

Thanks and Good Luck!! :)

Be Sure to Join Our Site (It’s FREE!) For A Chance To Win a $50 Target Gift Card

2009-05-08T03:57:00Z

The success of our site depends on you- the users so be sure to Join (it’s absolutely FREE) so you can take full advantage of the content and forums. We commit to not selling or forwarding your email address or information to any third party. This is very important to us.

All moms that join by June 15, will be entered in a draw to win a $50 Target Gift Card. The winner will be announced on the site on July 15. The rules are below:

1. Must join by 6/15 midnight.

2. Must use a valid email address and valid name

3. For every 3 original forum posts (ie: questions you post on forums) and 2 replies (ie: answers you provide to others questions) your name will be entered into the contest once. So the more you post, the greater the chances that you’ll win!

Join our site and good luck!

Welcome!

2009-05-08T03:10:00Z

As I mentioned in my letter on the Home Page, I am so happy that you have decided to visit Empowered Mommies.com. The purpose of this site is to help moms that are either hoping to conceive, are expecting or already have babies in their lives give them a healthy start. Our content will focus on these precious moments as we hope to create an online community where we can exchange meaningful information and knowledge to enhance the experience and make it as positive and empowering as possible.

I now have 3 infants: a 2 ½ yr old, a 15 month old and a newborn. With each, I’ve learned new things about pregnancy, labor/delivery and newborn care and I love the idea of sharing this knowledge with other moms and learning from their experiences too! This is where you come in! We want to hear from you through our forums and via email. Let us know what’s on your mind and what stage you’re at in your baby motherhood. Are you TTC, expecting or adjusting to life with a newborn? Is this your first or second/third child? How did you prepare for Labor? What was your biggest surprise? What would you do differently? These are some of the hundreds of questions and topics we can discuss.

Be sure to visit the Forums section our site to learn about our different topics of interest. Also- we will be updating our Resources section on a weekly basis with topical articles, toolkits and guides for different stages (ie: preconception, pregnancy, etc). As our site continues to grow and improve based on your feedback, we will be working to enhance its content to better serve your needs.

I look forward to connecting with you!