Friday, December 2, 2011

Pregnancy and me!

Nope not preggers again but the tickle is still there!

I have been with child 7 times. YES 7!

I have had 1 miscarriage, 1 C-Section and 2 ectopic pregnancies!

In addition to the above, I have also had in no particular order in each pregnancy:
Pre-eclampsia, Eclampsia, watched closely due to sugar in my urine, 1 Placenta Abrupto, 2 Pre-term births, UTI's, GBS, high blood pressure and terribly swollen kankles!

I felt gipped by the TLC channel, What to expect when you are expecting and numerous other things floating around that sell you on a seemingly, wonderful, uneventful birth, with a Doctor that actually listens or cares about your roller coaster emotional state!

Birth is a beautiful thing! Not to be rushed, panicking a new or even seasoned Moms by scaring the crap out of her if she has a glass of wine or took a dose of cold meds during her pregnancy.

Go with your instinct! I didn't have a Doula or a Birth Assistant to bounce ideas off of. Birth positions? Comfort measures? Oh, in a Lamaze they shared some but once you are in the moment your brain decides to rebel and I forgot to breathe!

I also had to remind myself like each child, each of they're births were equally just as different! Not textbook! I didn't look pretty. I sweated. I grunted. I puked. I shook. I was hot and then cold. I tuned everything out at one point and just went inward. Each birth was so unique!

Do what feels good! Believe in yourself Momma! You can do it!

Thursday, August 11, 2011

The Brewers Diet- Gestational Diabetes

I was on the verge of having Gestational Diabetes. I tried in vain and through prayer not to get this! I squeeked by! YEA ME! Many woman are not so lucky! In effort to learn more about how to prevent this, I was given the website for The Brewers Diet by my Midwife, Cindy Lybolt just in case.

The Diet created by Dr. Tom Brewer, was created in effort to help women have healthier pregnancies and babies! Much of the diet is Protein, Protein, Protein! The plan is on the site, as well as the guidelines to follow this.

http://www.drbrewerpregnancydiet.com/id13.html

Q: What is the Brewer Pregnancy Diet?

A: It is a diet that was developed in the 1950's and 1960's by an obstetrician, Dr. Tom Brewer, to help women have healthier pregnancies and healthier babies. In the process of his medical education, and researching the work of Hamlin, Strauss, Burke, and Ferguson--doctors who had worked on this issue in the 40 years previously--he discovered that the cause of pre-eclampsia and some other complications was an abnormal blood volume, caused by malnutrition, or food deficiency. The diet consists of 14 food groups. However, it can be summarized as starting with 4 basic components: 2600 calories, 80-120 grams of protein, salt to taste, and unrestricted weight gain

Personally I did notice a difference how I felt and I truly believe this helped me ALOT to get through the remaining months of my pregnancy. I'm not endorsing this but it did wonders for me! Please share with your Health care provider, Midwife or Doula before starting this diet or any other diet.

Gestational Diabetes

*Please check out my next posting on The Brewers Diet. I have heard great reviews of using this in order to help with pregancy. As always "You" are your be advocate! Inform and educate yourself on what alternative treatments are available so you can share with your health care provider, midwife or doula!*

Gestational diabetes

Gestational diabetes — Comprehensive overview covers symptoms, treatment of diabetes that develops during pregnancy.

Definition

Gestational diabetes develops during pregnancy (gestation). Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose) — your body's main fuel. Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby's health.
Any pregnancy complication is concerning, but there's good news. Expectant moms can help control gestational diabetes by eating healthy foods, exercising and, if necessary, using medication. Taking good care of yourself can ensure a healthy pregnancy for you and a healthy start for your baby.
In gestational diabetes, blood sugar usually returns to normal soon after delivery. But if you've had gestational diabetes, you're at risk for future type 2 diabetes. You'll continue working with your health care team to monitor and manage your blood sugar.

Symptoms

For most women, gestational diabetes doesn't cause noticeable signs or symptoms. Rarely, gestational diabetes may cause excessive thirst or increased urination.
When to see a doctor
If possible, seek health care early — when you first think about trying to get pregnant — so your doctor can evaluate your risk of gestational diabetes as part of your overall childbearing wellness plan. Once you become pregnant, your doctor will address gestational diabetes as part of your regular prenatal care. If you develop gestational diabetes, you may need more frequent checkups. These are most likely to occur during the last three months of pregnancy, when your doctor will carefully monitor your blood sugar level and your baby's health.
Your doctor may refer you to additional health professionals who specialize in diabetes management, such as an endocrinologist, a registered dietitian or a diabetes educator. They can help you learn to manage your blood sugar level during your pregnancy.
To make sure that your blood sugar level has returned to normal after your baby is born, your health care team will check your blood sugar right after delivery and again in six weeks. Once you've had gestational diabetes, it's a good idea to have your blood sugar level tested regularly. The frequency of blood sugar tests will in part depend on your test results soon after you deliver your baby.

Causes

Researchers don't yet know exactly why some women develop gestational diabetes. To understand how gestational diabetes occurs, it can help to understand how pregnancy affects your body's normal processing of glucose.
Your body digests the food you eat to produce sugar (glucose) that enters your bloodstream. In response, your pancreas — a large gland behind your stomach — produces insulin. Insulin is a hormone that helps glucose move from your bloodstream into your body's cells, where it's used as energy.
During pregnancy, the placenta that connects your growing baby to your blood supply produces high levels of various other hormones. Almost all of them impair the action of insulin in your cells, raising your blood sugar. Modest elevation of blood sugar after meals is normal during pregnancy.
As your baby grows, the placenta produces more and more insulin-blocking hormones. In gestational diabetes, the placental hormones provoke a rise in blood sugar to a level that can affect the growth and welfare of your baby. Gestational diabetes usually develops during the last half of pregnancy — sometimes as early as the 20th week, but usually not until later.

Risk factors

Any woman can develop gestational diabetes, but some women are at greater risk. Risk factors for gestational diabetes include:

Age greater than 25. Women older than age 25 are more likely to develop gestational diabetes.
Family or personal health history. Your risk of developing gestational diabetes increases if you have prediabetes — slightly elevated blood sugar that may be a precursor to type 2 diabetes — or if a close family member, such as a parent or sibling, has type 2 diabetes. You're also more likely to develop gestational diabetes if you had it during a previous pregnancy, if you delivered a baby who weighed more than 9 pounds (4.1 kilograms), or if you had an unexplained stillbirth.
Excess weight. You're more likely to develop gestational diabetes if you're significantly overweight with a body mass index (BMI) of 30 or higher.
Nonwhite race. For reasons that aren't clear, women who are black, Hispanic, American Indian or Asian are more likely to develop gestational diabetes.

Complications

Most women who have gestational diabetes deliver healthy babies. However, gestational diabetes that's not carefully managed can lead to uncontrolled blood sugar levels and cause problems for you and your baby, including an increased likelihood of needing delivery by C-section.
Complications that may affect your baby
If you have gestational diabetes, your baby may be at increased risk of:

Excessive birth weight. Extra glucose in your bloodstream crosses the placenta, which triggers your baby's pancreas to make extra insulin. This can cause your baby to grow too large (macrosomia). Very large babies are more likely to become wedged in the birth canal, sustain birth injuries or require a C-section birth.
Early (preterm) birth and respiratory distress syndrome. A mother's high blood sugar may increase her risk of going into labor early and delivering her baby before its due date. Or her doctor may recommend early delivery because the baby is growing so large. Babies born early may experience respiratory distress syndrome — a condition that makes breathing difficult. Babies with this syndrome may need help breathing until their lungs mature and become stronger. Babies of mothers with gestational diabetes may experience respiratory distress syndrome even if they're not born early.
Low blood sugar (hypoglycemia). Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth because their own insulin production is high. Severe episodes of hypoglycemia may provoke seizures in the baby. Prompt feedings and sometimes an intravenous glucose solution can return the baby's blood sugar level to normal.
Jaundice. This yellowish discoloration of the skin and the whites of the eyes may occur if a baby's liver isn't mature enough to break down a substance called bilirubin, which normally forms when the body recycles old or damaged red blood cells. Although jaundice usually isn't a cause for concern, careful monitoring is important.
Type 2 diabetes later in life. Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.

Untreated gestational diabetes can result in a baby's death either before or shortly after birth.
Complications that may affect you
Gestational diabetes may also increase the mother's risk of:

High blood pressure, preeclampsia and eclampsia. Gestational diabetes increases your risk of developing high blood pressure during your pregnancy. It also raises your risk of preeclampsia and eclampsia — two serious complications of pregnancy that cause high blood pressure and other symptoms that can threaten the lives of both mother and baby.
Future diabetes. If you have gestational diabetes, it's more likely to happen again during a future pregnancy. You're also more likely to develop type 2 diabetes as you get older. However, making healthy lifestyle choices such as eating healthy foods and exercising can help reduce the risk of future type 2 diabetes. Of those women with a history of gestational diabetes who reach their ideal body weight after delivery, fewer than one in four develop type 2 diabetes.

Preparing for your appointment

In most circumstances, you'll find out that you have gestational diabetes as the result of a screening test performed routinely during your pregnancy. If your blood sugar tests high, you'll likely be asked to come in for an appointment promptly. Your doctor will also schedule more-frequent regular prenatal appointments to monitor the course of your pregnancy.
Because appointments can be brief and there's often a lot of ground to cover, it's a good idea to prepare ahead of time for your appointment. Here's some information to help you get ready for your appointment and know what to expect from your doctor.
What you can do

Be aware of any pre-appointment restrictions. When you make your appointment, ask if you need to fast for blood work or if there's anything else you need to do to prepare for diagnostic tests.
Write down any symptoms you're experiencing, including any that may seem unrelated to gestational diabetes. Although gestational diabetes often doesn't cause any noticeable symptoms, it's a good idea to keep a log of anything unusual that you notice.
Write down key personal information, including any major stresses or recent life changes.
Make a list of all medications, including over-the-counter drugs and vitamins or supplements, that you're taking.
Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.

Questions to ask your doctor
Because time with your doctor is limited, writing down a list of questions will help you make the most of your appointment. List your questions from most important to least important in case time runs out. For gestational diabetes, some basic questions to ask your doctor include:

What can I do to help control my condition?
Can you recommend a dietitian or diabetes educator who can help me plan meals, an exercise program, and coping strategies that will work best for me? Will my insurance cover this advice?
What will determine whether I need medication to control my blood sugar?
What symptoms should prompt me to seek medical attention?
Are there any brochures or other printed material that I can take home with me? What websites do you recommend?

In addition to the questions you've prepared ahead of time, don't hesitate to ask your doctor to clarify anything you don't understand.
What to expect from your doctor
Your doctor is also likely to have questions for you, especially if you're seeing him or her for the first time. Being ready to respond may free up time to focus on any points you want to talk about in-depth. Your doctor may ask:

Have you experienced any increased thirst or excessive urination? If so, when did these symptoms start? How often do you have them?
Have you noticed any other unusual symptoms?
Do you have a parent or sibling who's ever been diagnosed with diabetes?
Have you been pregnant before? Did you have gestational diabetes during your previous pregnancies?
Did you have any other problems in earlier pregnancies?
If you have other children, how much did each weigh at birth?
Have you gained or lost a lot of weight at any time in your life?

What you can do in the meantime
You can take steps to control gestational diabetes with healthy choices as soon as you're diagnosed. If your doctor recommends further evaluation, make your follow-up appointments as soon as possible. Every week counts for you and your baby. Follow your doctor's advice, and take good care of yourself. Eat healthy foods, exercise and take time to learn as much as you can about gestational diabetes.

Tests and diagnosis

Medical experts haven't established a single set of screening guidelines for gestational diabetes. Some question whether gestational diabetes screening is needed if you're younger than 25 and have no risk factors. Others say that screening all pregnant women — no matter their age — is the best way to catch all cases of gestational diabetes.
When to screen
Your doctor will likely evaluate your risk factors for gestational diabetes early in your pregnancy.

If you're at high risk of gestational diabetes — for example, your body mass index (BMI) before pregnancy was 30 or higher or you have a mother, father, sibling or child with diabetes — your doctor may test for diabetes at your first prenatal visit.
If you're at average risk of gestational diabetes, you'll likely have a screening test for gestational diabetes sometime during your second trimester — between 24 and 28 weeks of pregnancy.

Routine screening for gestational diabetes

Initial glucose challenge test. You'll begin the glucose challenge test by drinking a syrupy glucose solution. One hour later, you'll have a blood test to measure your blood sugar level. A blood sugar level below 130 to 140 milligrams per deciliter (mg/dL), or 7.2 to 7.8 millimoles per liter (mmol/L), is usually considered normal on a glucose challenge test, although this may vary at specific clinics or labs. If your blood sugar level is higher than normal, it only means you have a higher risk of gestational diabetes. Your doctor will diagnose you after giving you a follow-up test.
Follow-up glucose tolerance testing. For the follow-up test, you'll be asked to fast overnight and then have your fasting blood sugar level measured. Then you'll drink another sweet solution — this one containing a higher concentration of glucose — and your blood sugar level will be checked every hour for a period of three hours. If at least two of the blood sugar readings are higher than normal, you'll be diagnosed with gestational diabetes.

If you're diagnosed with gestational diabetes
If you have gestational diabetes, your doctor will likely recommend frequent checkups, especially during your last three months of pregnancy. During these exams, your doctor will carefully monitor your blood sugar. Your doctor may also ask you to monitor your own blood sugar daily as part of your treatment plan.
If you're having trouble controlling your blood sugar, or you need to take insulin, or you have other pregnancy complications, you may need additional tests to evaluate your baby's general health. These tests assess the function of the placenta, the organ that delivers oxygen and nutrients to your baby by connecting the baby's blood supply to yours. If your gestational diabetes is difficult to control, it may affect the placenta and endanger the delivery of oxygen and nutrients to the baby. Tests to monitor your baby's well-being include:

Nonstress test. Sensors are placed on your stomach and connected to a monitor to measure your baby's heart rate, which should increase when the baby moves. If your baby's heart doesn't beat faster during movement, the baby may not be getting enough oxygen.
Biophysical profile (BPP). This test combines a nonstress test with an ultrasound study of your baby. There's a scoring system that enables your doctor to evaluate your baby's heartbeat, movements, breathing and overall muscle tone, and determine whether your baby is surrounded by a normal amount of amniotic fluid. Your baby's scores on heartbeat, breathing and movement help your doctor tell if the baby's getting enough oxygen. When the amniotic fluid is low, it may mean that your baby hasn't been urinating enough. This could indicate that over time the placenta has not been working as well as it should.
Fetal movement counting. You may perform this simple test at the same time as the nonstress test or the biophysical profile. You simply count how often your baby kicks over a set time. Infrequent movement may mean your baby isn't getting enough oxygen.

Blood sugar testing after you give birth
Your doctor will check your blood sugar after delivery and again in six to 12 weeks to make sure that your level has returned to normal. If your tests are normal — and most are — you'll need to have your diabetes risk assessed at least every three years. If future tests indicate diabetes or prediabetes — a condition in which your blood sugar is higher than normal, but not high enough to be considered diabetes — talk with your doctor about increasing your prevention efforts or starting a diabetes management plan.

Treatments and drugs

It's essential to monitor and control your blood sugar to keep your baby healthy and avoid complications during your pregnancy and delivery. You'll also want to keep a close eye on your future blood sugar levels. Your treatment strategies may include:

Monitoring your blood sugar. While you're pregnant, your health care team may ask you to check your blood sugar four to five times a day — first thing in the morning and after meals — to make sure your level stays within a healthy range. This may sound inconvenient and difficult, but it'll get easier with practice. To test your blood sugar, you draw a drop of blood from your finger using a small needle (lancet), then place the blood on a test strip inserted into a blood glucose meter — a device that measures and displays your blood sugar level.
Your health care team will also monitor and manage your blood sugar during labor and delivery. If your blood sugar rises, your baby's body may release high levels of insulin — which can cause low blood sugar in your baby right after birth.
Follow-up blood sugar checks are also important. After having gestational diabetes, you're at increased risk of later developing type 2 diabetes. Work with your health care team to keep an eye on your levels. Maintaining health-promoting lifestyle habits, such as a healthy diet and regular exercise, can help reduce your risk.
Healthy diet. Eating the right kinds and quantity of food is one of the best ways to control your blood sugar. Doctors don't advise losing weight during pregnancy — your body is working hard to support your growing baby. But your doctor can help you set weight gain goals based on your weight before pregnancy. Making healthy food choices can help prevent excessive weight gain, which can put you at higher risk of complications.
A healthy diet often focuses on fruits, vegetables and whole grains — foods that are high in nutrition and fiber and low in fat and calories — and limits highly refined carbohydrates, including sweets. No single diet is right for every woman. You may want to consult a registered dietitian or a diabetes educator to create a meal plan based on your current weight, pregnancy weight gain goals, blood sugar level, exercise habits, food preferences and budget.
Exercise. Regular physical activity plays a key role in every woman's wellness plan before, during and after pregnancy. Exercise lowers your blood sugar by stimulating your body to move glucose into your cells, where it's used for energy. Exercise also increases your cells' sensitivity to insulin, which means your body produces less insulin to transport sugar. As an added bonus, regular exercise can help relieve some common discomforts of pregnancy, including back pain, muscle cramps, swelling, constipation and trouble sleeping. Exercise can also help get you in shape for the hard work of labor and delivery.
With your doctor's OK, aim for moderately vigorous exercise on most days of the week. If you haven't been active for a while, start slowly and build up gradually. Walking, cycling and swimming are often good choices during pregnancy. Everyday activities such as housework and gardening also count.
Medication. If diet and exercise aren't enough, you may need insulin injections to lower your blood sugar. Between 10 and 20 percent of women with gestational diabetes need insulin to reach their blood sugar goals. Some doctors may prescribe an oral blood sugar control medication, such as glyburide. Other doctors feel more research is needed to confirm that oral drugs are as safe and as effective as injectable insulin to control gestational diabetes.
Close monitoring of your baby. An important part of your treatment plan is close observation of your baby. Your doctor may monitor your baby's growth and development with repeated ultrasounds or other tests. If you don't go into labor by your due date — or sometimes earlier — your doctor may induce labor. Delivering after your due date may increase the risk of complications for you and your baby.
Breast-feeding your baby. If you're interested in breast-feeding and it fits with your work schedule and other obligations, it may help you achieve your post-pregnancy weight goals and avoid later type 2 diabetes. Breast-feeding may also help your baby avoid later obesity and type 2 diabetes.

Coping and support

It's not easy to learn you have a condition that can affect your unborn baby's health. And worrying about your baby can make it harder to take care of yourself. You may find yourself eating the wrong foods or lacking the energy to exercise.
Keep in mind that the very steps that will help control your blood sugar level — such as eating healthy foods and exercising regularly — can help relieve stress and nourish your baby. These activities can also help prevent type 2 diabetes in the future. That makes exercise and good nutrition powerful tools for a healthy pregnancy as well as a healthy life — for you and your baby.
You'll probably feel better if you learn as much as you can about gestational diabetes. Talk to your health care team. Read books and articles about gestational diabetes. Join a support group for women with gestational diabetes. The more you know, the more control you'll feel.

Prevention

There are no guarantees when it comes to preventing gestational diabetes — but the more healthy habits you can adopt before pregnancy, the better. If you've had gestational diabetes, these healthy choices may also reduce your risk of having it again in future pregnancies or developing type 2 diabetes down the road.

Eat healthy foods. Choose foods high in fiber and low in fat and calories. Focus on fruits, vegetables and whole grains. Strive for variety to help you achieve your goals without compromising taste or nutrition.
Keep active. Exercising before and during pregnancy can help protect you against developing gestational diabetes. Aim for 30 minutes of moderate activity on most days of your week. Take a brisk daily walk. Ride your bike. Swim laps. If you can't fit a single 30-minute workout into your busy day, several shorter sessions can do just as much good. Park in the distant lot when you run errands. Get off the bus one stop before you reach your destination. Every step you take increases your chances of staying healthy.
Lose excess pounds before pregnancy. Doctors don't recommend weight loss during pregnancy — your body is already working overtime to support your baby's development. But if you're planning to get pregnant, losing extra weight beforehand may help you have a healthier pregnancy. Focus on permanent changes to your eating habits. Motivate yourself by remembering the long-term benefits of losing weight, such as a healthier heart, more energy and improved self-esteem.

STD's and pregnancy

STDs and Pregnancy
From U.S. Centers for Disease Control and Prevention
January 4, 2008

Can Pregnant Women Become Infected With STDs?
How Common Are STDs in Pregnant Women in the United States?
How Do STDs Affect a Pregnant Woman and Her Baby?
Should Pregnant Women Be Tested for STDs?
Can STDs Be Treated During Pregnancy?
How Can Pregnant Women Protect Themselves Against Infection?
Where Can I Get More Information?
Sources

Can Pregnant Women Become Infected With STDs?
Yes, women who are pregnant can become infected with the same sexually transmitted diseases (STDs) as women who are not pregnant. Pregnancy does not provide women or their babies any protection against STDs. The consequences of an STD can be significantly more serious, even life threatening, for a woman and her baby if the woman becomes infected with an STD while pregnant. It is important that women be aware of the harmful effects of STDs and knows how to protect themselves and their children against infection.

How Common Are STDs in Pregnant Women in the United States?
AdvertisementSome STDs, such as genital herpes and bacterial vaginosis, are quite common in pregnant women in the United States. Other STDs, notably HIV and syphilis, are much less common in pregnant women. The table below shows the estimated number of pregnant women in the United States who are infected with specific STDs each year.

STDs Estimated Number of Pregnant Women
Bacterial vaginosis 1,080,000
Herpes simplex virus 2    880,000
Chlamydia    100,000
Trichomoniasis    124,000
Gonorrhea      13,200
Hepatitis B      16,000
HIV        6,400
Syphilis     <1,000

How Do STDs Affect a Pregnant Woman and Her Baby?
STDs can have many of the same consequences for pregnant women as women who are not pregnant. STDs can cause cervical and other cancers, chronic hepatitis, pelvic inflammatory disease, infertility, and other complications. Many STDs in women are silent; that is, without signs or symptoms.
STDs can be passed from a pregnant woman to the baby before, during, or after the baby's birth. Some STDs (like syphilis) cross the placenta and infect the baby while it is in the uterus (womb). Other STDs (like gonorrhea, chlamydia, hepatitis B, and genital herpes) can be transmitted from the mother to the baby during delivery as the baby passes through the birth canal. HIV can cross the placenta during pregnancy, infect the baby during the birth process, and unlike most other STDs, can infect the baby through breastfeeding.
A pregnant woman with an STD may also have early onset of labor, premature rupture of the membranes surrounding the baby in the uterus, and uterine infection after delivery.
The harmful effects of STDs in babies may include stillbirth (a baby that is born dead), low birth weight (less than five pounds), conjunctivitis (eye infection), pneumonia, neonatal sepsis (infection in the baby's blood stream), neurologic damage, blindness, deafness, acute hepatitis, meningitis, chronic liver disease, and cirrhosis. Most of these problems can be prevented if the mother receives routine prenatal care, which includes screening tests for STDs starting early in pregnancy and repeated close to delivery, if necessary. Other problems can be treated if the infection is found at birth.

Should Pregnant Women Be Tested for STDs?
Yes, STDs affect women of every socioeconomic and educational level, age, race, ethnicity, and religion. The CDC 2006 Guidelines for Treatment of Sexually Transmitted Diseases recommend that pregnant women be screened on their first prenatal visit for STDs which may include:

Chlamydia
Gonorrhea
Hepatitis B
HIV
Syphilis
In addition, some experts recommend that women who have had a premature delivery in the past be screened and treated for bacterial vaginosis at the first prenatal visit.
Pregnant women should ask their doctors about getting tested for these STDs, since some doctors do not routinely perform these tests. New and increasingly accurate tests continue to become available. Even if a woman has been tested in the past, she should be tested again when she becomes pregnant.

Can STDs Be Treated During Pregnancy?
Chlamydia, gonorrhea, syphilis, trichomoniasis, and bacterial vaginosis (BV) can be treated and cured with antibiotics during pregnancy. There is no cure for viral STDs, such as genital herpes and HIV, but antiviral medication may be appropriate for pregnant women with herpes and definitely is for those with HIV. For women who have active genital herpes lesions at the time of delivery, a cesarean delivery (C-section) may be performed to protect the newborn against infection. C-section is also an option for some HIV-infected women. Women who test negative for hepatitis B, may receive the hepatitis B vaccine during pregnancy.

How Can Pregnant Women Protect Themselves Against Infection?
The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
Latex condoms, when used consistently and correctly, are highly effective in preventing transmission of HIV, the virus that causes AIDS. Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea, chlamydia, and trichomoniasis Correct and consistent use of latex condoms can reduce the risk of genital herpes, syphilis, and chancroid only when the infected area or site of potential exposure is protected by the condom. Correct and consistent use of latex condoms may reduce the risk for genital human papillomavirus (HPV) and associated diseases (e.g. warts and cervical cancer).

Where Can I Get More Information?
Division of STD Prevention (DSTDP)
Centers for Disease Control and Prevention
www.cdc.gov/std
Order Publications Online
CDC-INFO
1-800-CDC-INFO (800-232-4636)
TTY: 1-888-232-6348
In English, en Español
National Herpes Hotline
(919) 361-8488
National Herpes Resource Center
herpesnet@ashastd.org

Resources
CDC National Prevention Information Network (NPIN)
P.O. Box 6003
Rockville, MD 20849-6003
1-800-458-5231
1-888-282-7681 Fax
1-800-243-7012 TTY
E-mail: info@cdcnpin.org
American Social Health Association (ASHA)
P. O. Box 13827
Research Triangle Park, NC 27709-3827
1-800-783-9877

Sources
Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines 2006. MMWR 2006;55(no. RR-11).
Goldenberg RL, Andrews WW, Yuan AC, MacKay HT, St. Louis ME. Sexually transmitted diseases and adverse outcomes of pregnancy. Clinics in Perinatology 1997; 24(1): 23-41.
Institute of Medicine. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Eng TR, Butler WT, eds. Washington: National Academy Press. 1997.

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This article was provided by U.S. Centers for Disease Control and Prevention.

Saturday, June 11, 2011

Domestic Violence in Pregnancy

The time of pregnancy is a time for rejoicing and happiness! At least it should be... I loved being preggers! I disliked being preggers with my partner. I lived with much fear during my first 3 preg's. My last pregnancy was AWESOME! Terry was doting and joked about being woke up for cravings at 2 or 3 am but he enjoyed our pregnancy very much. I love being pregnant!

Anyway. I can feel both regret and shame during my pregnancy for staying as long as I did. I am filled with the choices of what could have been had I made better choices. I am just happy that I was able to find a bit of happiness with Terry. Even if he and I don't stay together for whatever reason. I have no plans to walk down the aisle again and if I do someday take that leap, I want it to be for love, not because we have a child together. Now don't get me wrong Terry is a great Dad and my best friend! But nothing is 100% nowadays. It has been a wonderful thing to not worry about getting punched in the stomach while pregnant or told "I hope you or the baby dies!" I can related to so much of the article below it's sad and pitiful!

Not to worry about being called "Fat" or told to stop eating. Or yell at the baby for crying when he/she can not understand. I cringe at the memories of shielding my little one's during some episode of craziness and fear.

The more I learn and grow the more I realize that health symptoms during not just pregnancy were not imagined and could be caused by the tremendous amount of stress I was under during those years of Abuse from my Gaslighter! To read more about me please visit my other blog on Domestic Violence/Family Violence as well:
http://www.hopewhentherewasnone.blogspot.com/

If you are experiencing any violence in your relationship please know it is not your fault! You don't deserve to be hit, broken or verbally put down! You are worthy of love, kindess and joy in your life!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
http://www.womensweb.ca/violence/dv/pregnancy.php

By Rachelle Drouin, Founder, Women's Web

Did you know?

Pregnant women have a higher risk of experiencing violence during pregnancy than they do of experiencing problems such as high blood pressure, gestational diabetes or premature rupture of membranes.

The incidence of violence in pregnancy may range from 4 to 17 percent. These figures may significantly underestimate the problem, as many women do not report their experiences of violence.

Of women who had ever been married, were 18 years of age or over and who reported violence during pregnancy by a marital partner, 40 percent reported that it began while they were pregnant.

Twenty-one percent of women abused by a current or previous partner were assaulted during pregnancy.

Women who were abused during pregnancy were four times as likely as other abused women to say they experienced very serious violence (beating, choking, gun/knife threats, sexual assault).

Pregnancy is a supposed to be a joyful time—a time of peace and safety. A woman's preoccupations turn to her unborn child, toward nurturance, toward the next generation. She hopes to raise a healthy child.

For many women, pregnancy marks the beginning of a turbulent and violent time. It's estimated 1 in 5 women will be abused during pregnancy. Even more alarming—as the murders of Liana White and Laci Peterson suggest—homicide during pregnancy now surpasses automobile accidents and falls as the leading cause of death.

How prevalent is domestic violence?

A May 2002 report by the United States Accounting Office to the Honorable Eleanor Holmes Norton, House of Representatives, on pregnant victims and the effectiveness of prevention strategies states that "of surveyed women who reported being raped or physically assaulted since the age of 18, about three quarters reported being victimized by a current or former spouse, cohabiting partner, or date."

In a 1993 Statistics Canada survey of 12,300 adult women, 29 percent of the women who had ever been married or involved in common-law relationships reported that they had been assaulted by their partners and 51% reported at least one incident of physical or sexual violence since the age of 16.

How prevalent is domestic violence in pregnancy?

Women in abusive relationships may hope pregnancy will reform an abusive partner. The sad reality, however, is that pregnancy is more likely to have the opposite effect: 1 in 6 abused women reports that her partner first became abusive during pregnancy. According to the Center for Disease Control, at least 4 to 8 percent of pregnant women—that's over 300,000 per year—report suffering abuse during pregnancy. Even more alarming: domestic violence is the leading cause of injury to American women between 15 and 44 and is estimated to be responsible for 20 to 25 percent of all hospital emergency room visits by women.

What constitutes abuse?

Pregnancy, while it's cause for excitement and elation, causes stress is any relationship and in many cases, it's a trigger for domestic violence.

The Center for Disease Control defines domestic violence during pregnancy as "physical, sexual, or psychological/emotional violence, or threats of physical or sexual violence that are inflicted on a pregnant woman." In a household survey cited in "Battering and Pregnancy" (Midwifery Today 19: 1998), it was found that pregnant women are 60.6 percent more likely to be beaten than women who are not pregnant.

Victims often see abusive behaviors as isolated, unrelated incidents. Yet, a partner's good behavior now is not necessarily a good predictor of future behavior: if a partner strikes a woman once, he or she is likely to do it again. Domestic violence often follows a clear pattern, frequently described in one or more of the following ways.

1.Tension may arise within a relationship. It may be the result of a minor disagreement.

2.Tension continues to build over a period of hours, or days or perhaps months.

3.Something will trigger an abusive incident. This assault may be physical, psychological, or sexual. (See Types of Abuse.)

4.A period of calm follows. This is often called the "honeymoon phase." The abuser may buy his/her partner gifts or lavish attention on her, often feeling sorry for what has happened.

5.Over time, the above cycle changes. More small incidents will occur, tension will increase, and the cycle will begin again. Both partners want to believe incidents of abuse will not repeat themselves, but they usually do.

Domestic violence doesn't necessarily have to be physical. It's important to understand that abuse is a pattern of behavior in which physical violence and/or emotional coercion is/are used to gain and maintain power or control in a relationship. Abuse may be continuous, or it may be a single incident of assault. Abuse may be physical, sexual, psychological/emotional or economic. For instance, say Liz Hart and Wanda Jamieson, authors of "Responding to Abuse During Pregnancy" (an overview paper available from the National Clearinghouse on Family Violence), abusers may try to control, limit, delay or deny a woman's access to health care practitioners and pre-natal providers. They may also refuse sex on the grounds that the pregnant body is unattractive, refuse access to food, threaten to leave, or threaten to report her to child welfare authorities as a potentially unfit mother. They may refuse to support a woman financially during her pregnancy or birth, refusing to allow her access to money to buy food and supplies, or force her to work beyond what is reasonable for her current endurance.

It should also be noted that for some women, their very pregnancy may itself be a form of abuse: a pregnancy conceived through sexual assault, marital rape, or from the woman's inability to negotiate contraceptive use. In fact, a fact sheet produced by the Pan American Health Organization states that women whose pregnancy is unintended or unwanted are four times more likely to suffer increased abuse. In abusive relationships, women and young girls are often forbidden to use contraceptives. Often used as a form of coercion and control, this type of dominance may even be an abusive partner's way to commit the woman to the relationship through pregnancy. Just as an abuser may control a woman's decision to continue her pregnancy, he or she may intimidate a woman into having an abortion. Some abused women may choose to have abortions out of fear.

The effects of domestic violence on pregnancy

Abuse is harmful not only to the woman being abused, but also to her baby, particularly if she takes blows to the abdomen. Such attacks can cause fetal fractures and cause injuries to or ruptures of the pregnant woman's uterus, liver, or spleen.

Studies have shown that during pregnancy, an abuser's attacks will generally focus on the breasts, abdomen, and genitals, resulting in serious consequences on the mother, fetus, and newborn and giving rise to maternal mortality and morbidity. It's linked to an increased risk of miscarriage, low birth weight, fetal injury, and fetal death.

Other complications may include:

•uterine prolapse

•antepartum hemorrhage

•premature rupture of membranes

•premature labor

•abruptio placenta

•vaginal infection from forced or unprotected sex with someone who has an infection

•increased first and second trimester bleeding

•headache

•irritable bowel syndrome

•chronic pelvic pain

•increased risk of contracting a sexually transmitted disease or HIV/AIDS

The effects of domestic violence on labor

During labor and delivery, an abuser may try to control a woman's decision to have an epidural, pain medication, or other interventions. He may demand that doctors restore his partner's vagina to its pre-birth state and may make disparaging comments about her sexuality or about the sex of the baby following the birth.

For women with a history of sexual abuse, say Hart and Jamieson, labor and delivery can be especially difficult. As labor progresses, increasing pain, the resulting loss of control, and repeated pelvic and genital exams can lead to myriad responses from laboring women. Some may appear too quiet and passive while others may become overly controlling and demanding. Some may scream and cry, while others may suffer uncontrollable terror. Still others may dissociate during labor or delivery. To physicians, nurses and other attendants unaware of the abuse, such behaviors may be difficult to understand. Those who do have knowledge of a woman's history of abuse have speculated that abuse plays a role in inadequate fetal descent and may prolong second stage labor.

The effects of domestic violence after birth

Following delivery, an abuser may increase abuse, use a woman's relationship with her baby as a weapon, and deny her access to the baby. He or she may:

•sulk or put her down when she spends time with the baby

•fail to support her or to help with the baby

•demand sex soon after birth

•make negative comments about her sexuality, attractiveness, and appearance

•blame her because the infant is the "wrong" sex

•put down her parenting ability

•threaten to or actually abduct the baby

•tell her she will never get custody of the baby

•make her stay at home with the baby

•prevent her from taking a job

•make or threaten false child abuse accusations

•withhold money for supplies

•blame her for the baby's crying

•force her to or forbid her to breastfeed

Because abuse undermines their sense of competence and confidence, the World Health Organization believes abused women may not be able to breastfeed successfully.

Signs of abuse

Domestic violence isn't restricted to women of a particular race, religion, education, class, or sexual orientation. Abused women come from all backgrounds and socioeconomic areas. Yet, because of a fear of reprisal, embarrassment, and ignorance of shelters and sources of financial assistance, many victims are afraid to disclose their abuse. Such factors make it difficult to determine who has been abused. It's therefore important for professionals and practitioners to know how to appropriately respond to these issues. (Professionals' response is addressed later in this article.)

Signs a pregnant woman has been or is being abused may include:

•a delay in seeking pre-natal care

•reluctance or refusal to attend pre-natal education

•unexplained bruising or damage to her breasts or abdomen

•continued use of or addiction to substances such as cigarettes, drugs or alcohol—all known to be harmful during pregnancy

•recurring or unexplained psychosomatic illnesses

•history of physical illness

Responding to abuse

How do victims typically respond?

Devastating as domestic violence is, victims of abuse often respond in equally devastating ways, engaging in self-destructive behaviors (such as alcohol and substance abuse) that risk harming both themselves and their baby. Because abusers maintain control of their victims through socially isolating them, abused women are often unable to access the support of family, friends, local services and statutory agencies. Embarrassed that their intimate partner is an abusive person, many will not seek out medical attention, attend pre-natal classes, or attend post-natal care. In addition, because of the heavy toll of domestic abuse on victims' self-esteem, victims may also suffer from depression, anxiety, panic attacks, eating disorders, and an increased dependence on their abuser. Some may even attempt—and sadly, achieve—suicide as a means of escaping an abusive situation.

In Hart and Jamieson's overview paper, "Responding to Abuse During Pregnancy", one victim describes the psychological impact of domestic violence thus:

The body mends soon enough. Only scars remain?but the wounds inflicted upon the soul take much longer to heal. And each time I relive these moments, they start bleeding all over again. The broken spirit has taken longest to mend; the damage to the personality may be the most difficult to overcome.

It's important not to overlook the other victims of domestic violence during pregnancy: that is, child witnesses to violence against their mother. Children who witness acts of violence may experience serious psychological or behavioral effects, including:

•increased acting out and aggressive behavior

•depression, anxiety, or panic attacks

•nightmares and sleep disturbances

•problems with social development

•problems at school (truancy, poor grades)

•post-traumatic stress disorder

•bedwetting

•separation anxiety

•inappropriate attitudes about violence

•self-blame

How should professionals respond?

Professionals can mean any number of persons able to offer help to an abused woman or refer her to appropriate sources of support. Professionals, say Hart and Jamieson, can denote physicians, nurses, pharmacists, counselors, therapists, social workers, health educators, police and emergency personnel.

Because of their tendency to miss pre-natal and post-natal appointments, abused pregnant women are sometimes seen by practitioners as deviant, time wasting, or self-absorbed. It's important for professionals to keep a grounded perspective and to be sensitive to the many issues faced by victims of domestic violence.

A paper commissioned by the College of Family Physicians of Canada's Maternity and Newborn Care Committee (January 2000) suggests that because of the prevalence of abuse in the general population, all pregnant women should be screened for past or current history of abuse. These questions, however, should never be asked in the presence of their domestic partners. Professionals should be particularly concerned where a woman's partner appears overly solicitous, prevents her from seeing professional in private, or does not allow her to answer questions for herself.

Because of shame, embarrassment, uncertainty about housing options and the availability of financial aid or because previous attempts at disclosure were met with disbelief or denial, women may be reluctant to disclose their abuse. Clinicians, too, may be afraid to ask about abuse because of a lack of understanding of the importance of domestic violence as a health and social issue. Practitioners' own experiences—as victims, perpetrators, or child witnesses—could also impact their readiness to broach the subject of abuse. As a result, professionals need to recognize and address how their values and personal experiences may affect their ability to respond appropriately.

Minimizing the seriousness of the abuse or questioning a victim's behavior and responses during abusive episodes are not appropriate responses. The important thing is that professionals respond in a manner that makes victims feel believed and supported. The importance of having a safety plan should be stressed. In addition, women will feel more comfortable disclosing if they are assured the details of their disclosure will remain confidential.

Some women may need help in making wise choices and in sorting out their past experiences of abuse. In addition to providing clinical care, health care providers should also be concerned with helping such women with their physical and psychological symptoms, referring them to other health care professionals or to community services for help in securing shelter, sorting out financial and legal options, and arranging further counseling for themselves and if applicable, for their children.

Where an abused woman has children, practitioners should ask whether they have ever been abused or if there is risk of abuse. Equally important, professionals should also determine whether the physical and emotional environment is safe for the children. If not, any concerns for their safety should be reported to the appropriate child protection services.

Professionals need to thoroughly document the abuse.

If someone you know is being abused…

If you believe someone you know is in an abusive relationship, share your concerns and ask how you can help. Domestic violence is a crime, punishable by law. No one deserves to be abused. Remind your friend or family member that the abuse is not her fault and that she is not alone. Encourage her to seek support and counseling from local services. Encourage her to talk to an advocate, help her devise a safety/escape plan, and encourage her to talk to a healthcare professional. Try to be as supportive and non-judgmental as possible: it's important to understand the effects of abuse and the myriad emotions (embarrassment, shame, self-recrimination, disorientation) experienced by victims of domestic violence—feelings undoubtedly amplified by pregnancy.

Facebook and me!

I have had a love affair with FB for sometime. At least that is what it seems like! I swear I spend WAY TOO much time on it! GIGGLE!

Today I created Little Cries Lullabies as a FB page to further add to already growing list of too much time on my hands. Please add me!

Took the kiddos out to Michigan City, IN Washington Park Zoo yestreday and had a nice time! The girls had gotten a kick out of the Avian hands on exhibit. I freaked out a bit when the birds got a little to close to my head! Fun was had by all!

?TTYL!

Healthy Mom & Baby Fair was today!

The Fair went great! I met a number of people to network with and also to get my name out there that I'm ready to jump in! I was pretty psyched! My table was a hit with the 10 and under crowd due to the Hershey Kisses, Rubber Ducks and interesting things to play with on the table. Oh and dare I not forget my Birth Ball was used on several occassions to bounce around and roll around! TEEHEE! It was fun!

The Vitamin Shoppe folks are very down to earth and so darned friendly! LOVE IT! I didn't realize how big the store was and the amount of items they had in stock was so super cool!

Tuesday, June 7, 2011

Breastfeeding- Nursing your Newborn, what to expect in the early weeks

Nursing your newborn — what to expect in the early weeks

This information is also found as part of the professional Breastfeeding Logs.

By Kelly Bonyata, BS, IBCLC

The First Week

How often should baby be nursing?
Frequent nursing encourages good milk supply and reduces engorgement. Aim for nursing at least 10 - 12 times per day (24 hours). You CAN'T nurse too often--you CAN nurse too little.
Nurse at the first signs of hunger (stirring, rooting, hands in mouth)--don't wait until baby is crying. Allow baby unlimited time at the breast when sucking actively, then offer the second breast. Some newborns are excessively sleepy at first--wake baby to nurse if 2 hours (during the day) or 4 hours (at night) have passed without nursing.
Is baby getting enough milk?
Weight gain: Normal newborns may lose up to 7% of birth weight in the first few days. After mom's milk comes in, the average breastfed baby gains 6 oz/week (170 g/week). Take baby for a weight check at the end of the first week or beginning of the second week. Consult with baby's doctor and your lactation consultant if baby is not gaining as expected.
Dirty diapers: In the early days, baby typically has one dirty diaper for each day of life (1 on day one, 2 on day two...). After day 4, stools should be yellow and baby should have at least 3-4 stools daily that are the size of a US quarter (2.5 cm) or larger. Some babies stool every time they nurse, or even more often--this is normal, too. The normal stool of a breastfed baby is loose (soft to runny) and may be seedy or curdy.
Wet diapers: In the early days, baby typically has one wet diaper for each day of life (1 on day one, 2 on day two...). Once mom's milk comes in, expect 5-6+ wet diapers every 24 hours. To feel what a sufficiently wet diaper is like, pour 3 tablespoons (45 mL) of water into a clean diaper. A piece of tissue in a disposable diaper will help you determine if the diaper is wet.
Breast changes
Your milk should start to "come in" (increase in quantity and change from colostrum to mature milk) between days 2 and 5. To minimize engorgement: nurse often, don’t skip feedings (even at night), ensure good latch/positioning, and let baby finish the first breast before offering the other side. To decrease discomfort from engorgement, use cold and/or cabbage leaf compresses between feedings. If baby is having trouble latching due to engorgement, use reverse pressure softening or express milk until the nipple is soft, then try latching again.

Call your doctor, midwife and/or lactation consultant if:

Baby is having no wet or dirty diapers
Baby has dark colored urine after day 3
(should be pale yellow to clear)
Baby has dark colored stools after day 4
(should be mustard yellow, with no meconium)
Baby has fewer wet/soiled diapers or nurses less
frequently than the goals listed here
Mom has symptoms of mastitis
(sore breast with fever, chills, flu-like aching)

Weeks two through six

How often should baby be nursing?

Frequent nursing in the early weeks is important for establishing a good milk supply. Most newborns need to nurse 8 - 12+ times per day (24 hours). You CAN'T nurse too often—you CAN nurse too little.
Nurse at the first signs of hunger (stirring, rooting, hands in mouth)—don't wait until baby is crying. Allow baby unlimited time at the breast when sucking actively, then offer the second breast. Some newborns are excessively sleepy—wake baby to nurse if 2 hours (during the day) or 4 hours (at night) have passed without nursing. Once baby has established a good weight gain pattern, you can stop waking baby and nurse on baby's cues alone.

The following things are normal:

Frequent and/or long feedings.
Varying nursing pattern from day to day.
Cluster nursing (very frequent to constant nursing) for several hours—usually evenings—each day. This may coincide with the normal "fussy time" that most babies have in the early months.
Growth spurts, where baby nurses more often than usual for several days and may act very fussy. Common growth spurt times in the early weeks are the first few days at home, 7 - 10 days, 2 - 3 weeks and 4 - 6 weeks.

Is baby getting enough milk?

Weight gain: The average breastfed newborn gains 6 ounces/week (170 grams/week). Consult with baby's doctor and your lactation consultant if baby is not gaining as expected.
Dirty diapers: Expect 3-4+ stools daily that are the size of a US quarter (2.5 cm) or larger. Some babies stool every time they nurse, or even more often--this is normal, too. The normal stool of a breastfed baby is yellow and loose (soft to runny) and may be seedy or curdy. After 4 - 6 weeks, some babies stool less frequently, with stools as infrequent as one every 7-10 days. As long as baby is gaining well, this is normal.
Wet diapers: Expect 5-6+ wet diapers every 24 hours. To feel what a sufficiently wet diaper is like, pour 3 tablespoons (45 mL) of water into a clean diaper. A piece of tissue in a disposable diaper will help you determine if the diaper is wet. After 6 weeks, wet diapers may drop to 4-5/day but amount of urine will increase to 4-6+ tablespoons (60-90+ mL) as baby's bladder capacity grows.

Milk supply?

Some moms worry about milk supply. As long as baby is gaining well on mom's milk alone, then milk supply is good. Between weight checks, a sufficient number of wet and dirty diapers will indicate that baby is getting enough milk.

Page last modified: 10/10/2005
Written: 2/27/03

Additional information

Breastfeeding Logs

Hunger Cues - When do I feed baby?

Resources: Is Baby Getting Enough Milk?

Normal Growth of Breastfed Babies

Breastfeeding - Getting Started

Information is Your Ally in preparing to breastfeed: 10 Tips for Success by Eva Lyford

Tips for juggling a newborn and toddler

Frequent Nursing

Worried about milk supply?

Is your milk supply really low?

My breasts feel empty! Has my milk supply decreased?

How can I find help for my breastfeeding problem?

@ other websites

The Importance of Colostrum by Paula Yount

What is Normal? by Paula Yount

Breastfeeding as Baby Grows by Becky Flora, IBCLC

Straight Talk About Real Babies: Defining New-Mom Expectations by Ann Calandro, BSN, RNC, IBCLC

Breastfeeding Through the Ages by Teresa Pitman

Monday, June 6, 2011

9 stages after birth of your baby

The First Hour After Birth: A Baby’s 9 Instinctive Stages

The first hours after birth are a developmentally distinct time for a baby and there are well documented short and long term physical and psychological advantages when a baby is held skin to skin during this time.

When a baby is in skin to skin contact after birth there are nine observable newborn stages, happening in a specific order, that are innate and instinctive for the baby. Within each of these stages, there are a variety of actions the baby may demonstrate.

Stage 1: The Birth Cry

The first stage is the birth cry. This distinctive cry occurs immediately after birth as the baby’s lungs expand.

Stage 2: Relaxation

The second stage is the relaxation stage. During the relaxation stage, the newborn exhibits no mouth movements and the hands are relaxed. This stage usually begins when the birth cry has stopped. The baby is skin to skin with the mother and covered with a warm, dry towel or blanket.

Stage 3: Awakening

The third stage is the awakening stage. During this stage the newborn exhibits small thrusts of movement in the head and shoulders. This stage usually begins about 3 minutes after birth. The newborn in the awakening stage may exhibit head movements, open his eyes, show some mouth activity and might move his shoulders.

Stage 4: Activity

The fourth stage is the activity stage. During this stage, the newborn begins to make increased mouthing and sucking movements as the rooting reflex becomes more obvious. This stage usually begins about 8 minutes after birth.

Stage 5: Rest

At any point, the baby may rest. The baby may have periods of resting between periods of activity throughout the first hour or so after birth.

Stage 6: Crawling

The sixth stage is the crawling stage. The baby approaches the breast during this stage with short periods of action that result in reaching the breast and nipple. This stage usually begins about 35 minutes after birth.

Stage 7: Familiarization

The seventh stage is called familiarization. During this stage, the newborn becomes acquainted with the mother by licking the nipple and touching and massaging her breast. This stage usually begins around 45 minutes after birth and could last for 20 minutes or more.

Stage 8: Suckling

The eighth stage is suckling. During this stage, the newborn takes the nipple, self attaches and suckles. This early experience of learning to breastfeed usually begins about an hour after birth. If the mother has had analgesia/anesthesia during labor, it may take more time with skin to skin for the baby to complete the stages and begin suckling.

Stage 9: Sleep

The final stage is sleep. The baby and sometimes the mother fall into a restful sleep. Babies usually fall asleep about 1½ to 2 hours after birth.

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