Breastfeeding Concerns

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

Breast anatomy

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.


  • 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:

Benefits of Breastfeeding

Breastfeeding is nature’s health plan. ~Author Unknown


I often encounter new mothers who do not want to breastfeed their newborns.  When I ask why not, I encounter various answers ranging from, “I don’t like the idea of breastfeeding” and “I don’t think my baby is getting enough milk that way” to “my breasts hurt all the time.”

If you choose to or have to feed your baby with formula, your baby will still grow and thrive, but breast milk and the act of breastfeeding have advantages that formula will never replace. This post contains reasons for breastfeeding.


Why should I breastfeed?

Benefits to the baby:

  • Antibodies in human milk passed from mother to baby help protect the child in the first few vulnerable months and some studies have shown that this immunologic protection remains as the child grows and may protect against asthma and allergies later in life
  • Human milk is easier to digest and babies who are breastfed usually suffer fewer problems with constipation or stomach concerns.
  • Breast milk naturally contains nutrients essential for growth that change as the baby ages. Formula cannot replicate this.
  • No BPA risk
  • Breastfeeding immediately after vaccinations or blood tests can help reduce pain and stress  for the baby


Benefits to the mother:

  • Bonding time with your baby
  • Helps reduce risk of ovarian and breast cancer in addition to heart attack and stroke (risk reduction seen after 6 months of breastfeeding)
  • Reduced maternal stress during periods of breastfeeding
  • Speeds up uterine contraction back to original size pre-pregnancy
  • Burns an extra 400-600 calories a day and can help new mother lose pregnancy weight
  • Can reduce post childbirth pain and bleeding, especially after a C—Section
  • No need to carry bottles and formula cans or worry about lack of food for baby if you are out of house longer than expected (breasts are always with you J)
  • No financial expenditures
  • Breastfeeding is a reliable form of contraception if you are exclusively breastfeeding, if your menstrual periods have not resumed, and if your baby is less than six months old (if the previous criteria are not met, you may want to make sure you have back up contraception)


Benefits to the environment:

  • No unnecessary packaging or waste
  • No need to wash bottles




References and resources

  4. The Breastfeeding Answer Book by Nancy Mohrbacher and Julie Stock

Holiday Safety Tips


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.


  • “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


  • 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


  • 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.

Let’s Talk About the Flu Virus and Flu Vaccines Part 3

He who cures a disease may be the skillfullest, but he that prevents it is the safest physician. 

—-Thomas Fuller, an English churchman and historian (1608 – 16 August 1661)

Myths about the Flu vaccine

Myth #1:  “Every time I get the flu shot I get the flu.”

Truth: When you have gotten the flu shot in the past, you may have had a mild immunologic reaction common with all vaccines. This reaction can cause a low grade fever and some malaise, but it is not the flu.  Additionally, if you wait too long into the season to get the flu vaccine, you may already have been exposed to the virus.

Myth #2: “I never get the flu shot and I never get sick.”

Truth: This may be true. However, the flu virus mutates every year and this causes a slightly different virus every year.  Every few years, the virus is completely different, so even if you didn’t get the flu last year, you are still vulnerable to getting the flu this year.

Myth #3:  “I got the flu shot 2 years ago, so I am covered.”

Truth: As in previous answer, the flu vaccine only covers an individual for the current flu season (now 2013-2014).  In order to be protected, you need to receive a new vaccine every year. Additionally, getting infected with the flu does not offer immunity either.

Myth #4: “Only babies and old people need the flu shot.”

Truth: Babies and older people are more susceptible to serious flu virus consequences due to age and lowered immunity. However, anyone can get infected with the flu and those with chronic diseases (such as diabetes, asthma, cardiac conditions) should receive flu vaccine no matter the age. The Centers for Disease Control and Prevention advise all individuals, 6 months and older, to get the flu vaccine.

Myth #5: “I am pregnant/breast feeding and I don’t think I should get a flu shot”

Truth: This is exactly the time to receive a flu vaccine.  Pregnant women are susceptible to infection and if infected, can pass the virus on to their fetus. This can cause severe consequences for the baby—even death.  If a woman is breastfeeding and gets sick, she may pass the virus on to her newborn while breastfeeding (flu virus is not passed through breast milk, but since Mom may sneeze or cough with baby close to her face, she may pass on virus in this manner).  Breastfeeding Moms who are sick should wear a mask and a flu vaccine can prevent the infection in the first place.

 flu shot image

More questions or concerns about the flu or flu vaccines?  Call us at 307-8087 or come by the office and Dr. Days will be happy to answer them.


Let’s Talk About the Flu Virus and the Flu Vaccines Part 2

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 McWilliamsLife 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!

Let’s Talk about the Flu (Part 1)


“Influenza viruses are notorious for their rapid

mutation and unpredictable behavior.”

—-Margret Chan, Director-General of the World Health Organization 2006-present

It is flu and cold season again and everywhere flu shots are being advertised.  Many people and families have questions about how the flu is different from other viruses and why they should get a flu shot for themselves or their children. We will discuss this in three different posts.  This first one explains a little about the flu virus, how it is transmitted and how to recognize the symptoms.

What is the InFluenza Virus?

  • There are several strains/types of flu virus that affect humans and these strains may change each year.
  • Because of the changing strains, humans are unable to develop immunity to the flu
  • The viral infection primarily  affects the nose, throat and lungs
  • Illness can be mild, moderate or severe to life-threatening
  • Flu complications can include pneumonia, dehydration, or other secondary infections
  • Flu season is general from October to May
  • “Influenza-related complications cause more children to be hospitalized than any other vaccine-preventable disease.” (CDC statement)


How can you get the flu?

  • Flu virus is gets into a person’s body through the mouth or nose
  • Flu is spread when you touch a contaminated object (table, chair, toy) and then touch your mouth or nose, and when a sick person breathes, sneezes or coughs on you.
  • Flu germs can live on objects for up to 8 hours
  • The flu virus is highly contagious and has a contagious period of 1 day before a person has symptoms to 2 weeks after developing symptoms!
  • Children younger than 2 years and those in daycare/school are more susceptible to the virus

Flu Symptoms vs. Cold Symptoms



Timing of Symptoms

Appear gradually

Appear Abruptly







Flushed skin









Sore throat



Runny or Stuffy Nose



Body aches


Moderate to severe



Mild to severe



Mild to severe







Red and Watery Eyes



West Nile Virus, or The Problem With Mosquitoes


“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





Flash Floods


Row, row, row your boat, gently down the stream……

Summer in El Paso can get very hot and then suddenly we can get several days of nonstop downpour.  These conditions make it very likely that we will have flash flooding, especially as the “monsoon” season of late July and August begins. A flash flood is when the roads suddenly turn into racing streams that can carry people and vehicles away.

How can you keep yourself and your children safe in flash flood conditions?

First of all, listen for local weather advisories on the radio or TV that will issue either a flash flood watch or a flash flood warning.

The National Weather Service will issue a Flash Flood Watch when heavy rains may result in flash flooding in a specific area. In this case you should be alert and prepare for the possibility of a flood emergency which will require immediate action.

Flash Flood Warning will be issued when flash flooding is occurring or is about to occur in a specified area. If your area is placed under a warning, you should move to safe ground immediately.

Flash Flooding usually occurs within 6 hours of a heavy rain event.


  1. Post emergency numbers near every home phone and program the numbers into cell phones.
  2. In hilly terrain, flash floods can strike with little or no advance warning. Distant rain may be channeled into gullies and ravines, turning a quiet stream into a rampaging torrent in minutes. Never camp on low ground next to streams since a flash flood can catch you while you’re asleep.
  3. Do not cross flowing stream on foot where water is above your ankles.
  4. If you are driving, don’t try to cross water-filled areas of unknown depths. If your vehicle stalls, abandon it immediately and go to higher ground. Rapidly rising water may sweep the vehicle and its occupants away. Many deaths have been caused by attempts to move stalled vehicles.
  5. Be especially cautious at night. It’s harder to recognize water danger then.
  6. Don’t try to outrace a flood on foot. If you see or hear it coming, move to higher ground immediately.
  7. Be familiar with the land features where you live, work, and play. It may be in a low area, near a drainage ditch or small stream, or below a dam. Be prepared!
  8. Stay tuned to local weather reports for the latest statements, watches and warnings concerning heavy rain and flash flooding in your area, report it to the National Weather Service.

After the rain is over and it is possible to walk/drive around, make sure your children:

  • do not play in dirty water—many infections occur after flash floods
  • do not walk around without shoes
  • do not play with stray or injured animals—they may bite or be very sick
  • are protected with bug spray since mosquito season is also at same time as flash floods

Summer Day Fun #3

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



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




Summer Day Fun #2

Summer Day Fun

The days are getting hotter and the kids are out of school.  You need a good way to keep everyone cool. What can you do but head to the pool?

Days at the pool or lake or ocean are often the way we spend our summers and children adore the water and the sunny days. However, summer can also 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.

Danger #2


  • Infants (under 1 year):  Children of this age are most at risk for drowning in bathtubs or large buckets.
    • Never leave your child alone near any water (esp. bathtubs), even for a few seconds
    • Close toilet lids and empty all large buckets
    • Make sure bathroom locks from outside only
    • Toddlers and preschoolers (1-5 years): Swimming Pools are #1 drowning risk for pre-school age children
      • Watch your child at all times around water
      • If he/she is in swimming pool, an adult needs to be in the pool with him/her
      • Swimming lessons do not mean your child can swim well enough to be alone
      • Keep toys away from the pool so children are not tempted to be near water
      • Put a fence with a gate around your home pool  (gate should open away from pool)
    • School-Age Children (5-12 years):
      • Children still need to be watched by an adult at all times
      • Swimming lessons are helpful
      • No diving unless water is very deep and parent/teacher is watching
      • Floaties give false sense of security so should not be used to swim in a deep pool (life vests are better)
      • No running near pools
      • At pool parties, make sure children know not to play rough in the water (no pushing, dunking, etc.)
    • Teenagers (over 12 years):
      • Make sure teen knows not to dive in shallow areas, in above ground pools or through inner tubes
      • No swimming while drinking alcohol (no alcohol at this age anyway)
      • No  horsing around (dunking, pushing, throwing) with others in or near pool
      • Take diving/swimming classes
      • Take CPR/water safety classes

Always keep a working phone nearby with 911 on speed dial in case of problems