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A baby nursing at a mother’s breast… is an undeniable affirmation of our rootedness in nature. ~David Suzuki

This post continues where the previous left off.  Let’s say you want to breastfeed, but you have encountered a few problems.  The most common issues women face in breastfeed involve getting the baby to latch correctly.  If your baby is not latching, you may have problems with milk production, sore nipples and mastitis.

Take a look at the image above and learn the different parts of your breast.  In order to prevent nursing problems for both baby and mother, the baby’s mouth has to be wide open and needs to encompass the milk ducts, not just the nipple opening.  If the baby’s lips cover the entire or majority of the areola, generally this is a correct latch.  When the baby is latched correctly, it is difficult to pull the baby off the breast until baby is finished sucking.

Maternal concerns:

 

What is a Sore Nipple?

• Shooting or stabbing pains in nipple when baby tries to latch on.
• Usually occurs 1-2 weeks after birth
• Sometimes a small crack or cut plus some bleeding is seen on nipple tip

If you develop Sore Nipples:

• Reposition baby so that mouth is covering areola (as mentioned above)
• Do not pull baby away without breaking the suction
• Do not allow baby to twist or pull nipples
• Feed baby before he/she is starving
• Make sure nipple is dry between feedings
• For the pain, mother may use ice cube or cold pack on nipple after feeding, may take Ibuprofen or can use lanolin cream/breast milk to moisturize and soothe sore nipple

 

What is an Engorged Breast?

• A full tender breast and sometimes tenderness extends to underarm area
• Can occur in one or both breasts
• Sometimes is associated with low-grade fevers
• Nipple and breast are swollen and baby has difficulty latching on
• Usually experienced in the first week after birth when milk “let-down” occurs

If you have Engorged Breasts:

• Feed baby early (as soon as he/she looks around with open mouth)
• Position properly (as noted before)
• Can express or pump breasts before feeding baby to soften the breast and relieve pressure
• Massage breasts and use warm compresses or warm water in shower to soften breasts

What is Mastitis?

• A tender, red swelling in one area of the breast
• High fevers
• Fatigue and muscle pains
• Can occur after a history of a cracked nipple or engorgement, but it also may occur suddenly without a history of problems

 

If you have Mastitis:

• Continue to breastfeed your baby, especially on the affected breast
• Drink and eat well; it is important to continue your hydration
• Tylenol or Motrin for pain and fever is ok to use
• Pump breast or express milk on the tender side at least 4 times a day in addition to regular feedings
• Contact your obstetrician for an antibiotic prescription

 

Baby concerns:

Nasal Congestion

• May affect one or both nostrils and will cause baby to have breathing problems when eating. Also affects a formula fed baby, but more often causes problems in breastfed babies
• See if baby latches better to one breast versus the other and use saline drops 2-3x/day with nasal suction to decongest baby.

Tongue-Tie

• Is an abnormally short frenulum, inserting at or near the tip of the tongue
• May prevent baby from projecting tongue out enough to exert pressure on milk ducts.
• Can cause early frustration for baby, causing him/her to reject breast
• Can be easily eliminated by getting a dentist or oral surgeon to clip the frenulum (tie)

Oral Thrush

• Caused by a yeast infection (not abnormal in infants)
• May cause baby to feel pain with eating
• Mothers may see red, cracked nipples at same time
• Easily treated with an antifugal medicine prescribed by a pediatrician

 

For more info and help with breastfeeding, check out the following websites:

• www.babycenter.com/breastfeeding–problem-solver
• http://www.babycentre.co.uk/c545887/breastfeeding-problems-and-solutions
• http://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Warning-Signs-of-Breastfeeding-Problems.aspx

The holidays with kids can be a wonderful time of year.  No matter the age, children love holidays.  They love the family get-togethers, the lights and decorations, the desserts, school vacations and, of course, the presents!  However, holidays can also bring up multiple safety issues.  Read some of the tips below so that you can avoid spending your holiday in the Emergency Room.

Decorations:

• “Bubble lights” may contain methylene chloride and can be poisonous if a child drinks the fluid from more than one light (even if labeled nontoxic).
• Snow sprays may be harmful if the aerosol propellants are used improperly
• Light bulbs, tinsel, and small toys are potential choking hazards for small children because they may block the airway. The general rule of thumb is that if it’s small enough to fit in the mouths of babies and toddlers, it’s too small to play with
• Ornaments made of glass or ceramic can break easily. This can be a double hazard causing cuts on hands and choking if broken pieces are swallowed
• Ornament hangers may cause cuts, skin irritation, or eye damage if touched or swallowed by children

Plants/Flowers:

• Mistletoe, holly and poinsettias are common decorations or gifts during the holidays. These plants are considered poisonous and should be kept out of the reach of kids.
• Symptoms of plant poisoning can include rashes, nausea, vomiting, and diarrhea.
• The needles of Christmas trees can cause painful cuts in the mouth and throat of a child who swallows them
• If you suspect that your child has eaten any part of a plant, immediately call your doctor or the National Poison Center: (800) 222-1222

Fires:

• Keep your tree secured in a sturdy stand so that it doesn’t tip over and keep it away from all heat sources such as electrical outlets, radiators, and space heaters.  If you buy an artificial tree, be sure that it is labeled “fire-retardant.”
• Avoid using real candles on a tree because if the needles are dry they can easily catch fire. Never leave the room with candles burning — it only takes a minute for a spark from a candle to burst into flames.
• Circuits that are overloaded with lights, decorations, and accessories can start a fire. Don’t overload indoor or outdoor electrical outlets.
• Have your fireplace inspected before you light your first fire of the season. A chimney professional can clean your fireplace and ensure that it is safe to use. You can protect your family by using a sturdy fireplace screen when burning fires. Never burn paper or pine boughs, since those materials can float out of the chimney and ignite a nearby home.
• Practice fire safety, have a family emergency plan in the event of a fire, and check smoke detectors before you put up your holiday decorations.

Family Visits:

• Family members can be well intentioned, but make sure all visitors follow house rules and that all foods/gifts for the children are okayed by you first.
• Sick family members should stay away from young babies and all hands should be washed frequently
• If you feel overwhelmed by family, take a quick break (a short walk outside, 10 minutes alone in an empty room, etc.). Don’t take the holiday stress out on your children.

Food and Drink:

• Common holiday foods such as peanuts or popcorn are potential choking hazards and should not be given to children under age 4

• Alcohol poisoning is a common risk for children during the holiday season. Take care to remove all empty and partially empty cups as soon as possible. Because kids imitate adults, many may drink the beverages they see adults drinking. Children become “drunk” much more quickly than adults, so even small amounts of alcohol can be dangerous.

• Food poisoning is another potential holiday hazard. Practice food safety by washing hands, utensils, dishes, and anything else that comes in contact with raw meat, including poultry and fish, and raw eggs before and after use. Don’t contaminate a serving dish with raw meat. Store leftovers properly and heat them thoroughly before serving.

• Chocolate goodies or caffeinated sodas are ok in small doses—large doses can cause hyperactivity and insomnia in older children and can be dangerous for babies and pets.

School Vacations:

• Use time of from school for more than just video games and TV—read part of a fun age-appropriate book to your child every night.
• Get outside and exercise if the weather permits. Playground play or a walk around the block can help both you and your children work off holiday weight gain.

 

Above all during this holiday season, DON’T DRINK AND DRIVE!!  Make sure your teenagers (and any guests) understand the dangers of drinking and driving—both as a driver and a passenger. Give them the numbers for safe rides home before they head out to a friend’s party.

“The more severe the pain or illness, the more severe will be the necessary changes. These may involve breaking bad habits, or acquiring some new and better ones.”

—Peter McWilliams, Life 101

Prevention of the Flu

• Single best way to prevent the flu virus is to get a flu vaccine every year before the start of the flu season (for every person over the age of 6 months)
• To help stop the spread of the flu, cough or sneeze into the crook of your arm or into a tissue
• Wash hands frequently
• If you live in a household with a sick person, a small baby (younger than 6 months of age) or an adult over the age of 65, it is more important for you to receive the flu vaccine
• Disinfect all toys after a child has been sick. Replace toothbrushes after illness.

 

If you think your child has the Flu

• Contact your pediatrician right away, especially if your child has asthma, diabetes or  is younger than 1 year of age
• Within the first 48 hours of illness, flu symptoms can be minimized by getting a prescription for Tamiflu.
• If child is severely ill (prolonged fevers > 104 degrees F, trouble breathing, excessive fatigue or severe dehydration)  go to an Emergency Room.
• Control milder symptoms at home with lots of clear liquids (water, Pedialyte/Gatorade, broth), Tylenol and rest.
• If your child has a fever > 100.5 degrees F, wait 24 hours after fever is gone before sending him/her back to school or daycare
• Do not take a sick child to school, daycare, the mall or parties!

“Mosquitoes remind us that we are not as high up on the food chain as we think.”

–Tom Wilson (American actor, writer and comedian)

So far in Texas this summer, only 2 human cases of West Nile Virus has been reported.  However, the period when most people get infected is from July-September. Please keep in mind the following facts:

What is West Nile Virus (WNV)?

• WNV is a virus most commonly spread by infected mosquitoes
• WNV can cause febrile illness, encephalitis (inflammation of the brain) or meningitis (inflammation of the lining of the brain and spinal cord)

How do humans get infected?

• Most people get infected with West Nile virus by the bite of an infected mosquito
• Mosquitoes become infected when they feed on infected birds
• Infected mosquitoes can then spread the virus to humans and other animals
• Rarely, it can be spread through blood transfusions, organ transplants, and from mother to baby during pregnancy, delivery, or breastfeeding

What are the symptoms?

• No symptoms in most people. Most people (70-80%) who become infected with West Nile virus do not develop any symptoms and will never have any problems.
• Fever in some people. About 1 in 5 people who are infected will develop a fever with other symptoms such as headache, body aches, joint pains, vomiting, diarrhea, or rash. Most people with this type of West Nile virus disease recover completely, but fatigue and weakness can last for weeks or months.
• Severe symptoms in a few people. Less than 1% of people who are infected will develop a serious neurologic illness such as encephalitis or meningitis (inflammation of the brain or surrounding tissues). The symptoms of neurologic illness can include headache, high fever, neck stiffness, disorientation, coma, tremors, seizures, or paralysis.

 

What can you do to protect yourselves and your children against WNV?

The most effective way to avoid West Nile virus disease is to prevent mosquito bites:

• Use insect repellents when you go outdoors. Repellents containing DEET, picaridin, IR3535, and some oil of lemon eucalyptus and para-menthane-diol products provide longer-lasting protection.
• Wear long sleeves and pants from dusk through dawn when many mosquitoes are most active.
• Install or repair screens on windows and doors. If you have it, use your air conditioning.
• Help reduce the number of mosquitoes around your home. Empty standing water from containers such as flowerpots, gutters, buckets, pool covers, pet water dishes, discarded tires, and birdbaths.

 

For more info, go to http://www.cdc.gov/westnile/index.html

 

 

 

 

Summer can be the setting for disaster from water and sun if you do not take precautions.  I will highlight a different potential summer danger once a week during June.

Sometimes we like to play at the park and some kids will soon start sports practice for school, but beware of exercise in hot weather.

Danger #3

Exercise-Related Heat Illness (ERHI):

EHRI occurs when the weather is very hot or very humid and the child or teen is doing exercise or playing sports. When you exercise, your muscles produce more heat, so even in a cool environment, you will start to feel warmer with exercise.  Sweating helps cool the body down, but if you don’t sweat appropriately or aren’t replacing the fluids lost in sweat, your body will be unable to get rid of the excess heat, resulting in ERHI.  Children tend to be at a greater risk for developing EHRI.

Here are some of the signs of EHRI and the progression that can happen if precautions are not implemented:

Type of EHRI	Symptoms	Treatment
Heat cramps	Painful muscle contractions, usually in the legs. Normal body temperature Sweating is normal	Stop exercising & stretch affected muscle Drink Gatorade or another salt-replacement fluid
Heat Exhaustion	Body temperature increases up to 104° F Child feels tired; experiences nausea, vomiting, dizziness, fainting. Skin is flushes, but moist	Stop exercising Move to shaded, cool area Drink Gatorade or other electrolyte replacement fluid If child unable to drink—take to nearest ER
Heat Stroke	Body temperature is greater than 104° F Child is combative & confused, experiencing seizures or is unresponsive after fainting Skin is flushed, hot and dry—no sweat	Call 911—this is life threatening Cool the child’s body down immediately in any way possible (air conditioned room, cool cloths, ice packs, etc)

 

 

Tips to prevent EHRI:

• Schedule activities at cooler parts of the day (early morning or late afternoon)
• Consider cancelling or postponing events if the day is extremely hot or extremely humid
• Kids/teens should gradually adjust to exercising by increasing activities slowly over the first 2 weeks of practice
• Dress appropriately for the weather—do not use excess clothing or equipment
• Schedule breaks every 10-15 minutes so children can drink liquids to stay hydrated—4-8 ounces should be drunk at each break
• Cold water and sports drinks should be available before, during and after every activity