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Tandem Nursing

Just found out that you are pregnant again while nursing a toddler? Well, you have a decision to make about nursing, one that many mothers have had to make in similar situation.

There are two options. You can choose to wean your toddler while pregnant, so you can focus on nursing your new baby. On the flip side, you can choose to nurse them both, also known as tandem nursing.

What is Tandem Nursing? 

Tandem nursing is best defined as nursing two children of different ages. It is quite different from nursing twin babies. In tandem nursing, the mother nurses a baby and a toddler at the same time.

There are a few concerns about tandem nursing, but the first thing you should know is that it is safe. Generally, many mothers manage to do tandem nursing as long as they have a healthy pregnancy such as no cramps or spotting. If you are unsure, continuously seek advice from your doctor during prenatal checkup.

However, there are certain red flags that may lead to weaning your toddler:

  • High-risk pregnancy or risk for miscarriage
  • Multiple pregnancy
  • Uterine pain or bleeding

The biggest concern mothers have about tandem nursing is the milk supply. You do not have to worry about this if you want to nurse. Your breast produces enough milk to meet demand. This means that as long as you do tandem nursing, your breast will provide enough breast milk for both of your children.

You may also consider feeding your newborn first before his/her sibling.  Now that you know that tandem nursing is safe, the next question is, how do you do it?

There are no right or wrong ways to tandem nursing. Each mother finds their groove and does what feels best for her and her children.

However, there are a few suggestions that you can try out. Nurse your children simultaneously, or one after each other. Positioning and timing depend on you and your children. As long as everyone is happy, fed, and satisfied, you are doing great.

Why Tandem Nurse? 

There are a lot of advantages. Here are a few;

  • It increases your milk supply fast. Your body will produce enough breast milk for two, so you might not deal with underproduction.
  • Nursing your toddler simultaneously with your newborn can reduce your chances of experiencing an engorged breast.
  • It is a great bonding experience for everyone, especially for your toddler and your baby. Toddlers can feel threatened with the presence of a newborn. Tandem nursing helps reassure the toddler of your attention and care while also introducing him/her to the new baby.
  • The only disadvantage here is that it is exhausting. Nursing two children at the same time is not a walk in the park, but you can overcome this by eating healthy, staying hydrated, and resting.

In conclusion, tandem nursing is a great way to feed your newborn and your toddler while also bonding with them. It is safe and healthy all-round, but if it takes a toll on you, you can try weaning your toddler early in the process. A ‘no offer, no refuse’ strategy can be very effective for this.

Is It Safe To Have an X-ray During Pregnancy?

Pregnancy is a complex phase that requires you to take great care of yourself by eating right, avoiding cigarettes and alcohol, and also observing basic hygiene  to protect you and your unborn baby from infections. Pregnant women typically visit the hospital or health care providers several times from the first trimester until  when their baby is born.

Just like drugs, diagnostic x-rays and radiations in the abdominal area should be done with precaution during pregnancy. At some point in your pregnancy, your doctor may require a diagnostic x-ray to get important and life-saving information about your medical condition.

Of course, diagnostic X-rays have their risks, as they could cause harm to your unborn child but they can sometimes be unavoidable, especially if you show symptoms of life-threatening conditions that require immediate treatment. The truth is that X-rays can be paramount, especially if they will give your doctor pertinent information that is needed to treat you.

The risk of harming your unborn baby through an X-ray greatly depends on a few factors. X-rays performed on your legs, head, hands, teeth or chest will rarely pose any risk to your baby because your reproductive organs are not exposed to the direct X-ray beam. Besides, you will most likely wear a lead apron during the procedure to protect you against radiation. On the other hand, an abdominal x-ray can expose both your belly and unborn baby to the direct beam and this could be dangerous to your baby.

The extent of the damage on your unborn child will also depend on the gestational age of the pregnancy, and the amount of radiation it is exposed to. There are indications that exposure to high doses of radiation during the first two weeks of conception could cause a miscarriage, while exposure at two to eight weeks of pregnancy could result in fetal growth restrictions and birth defects. Your child could also be born with intellectual and learning disabilities if the unborn baby was exposed to radiation between eight to sixteen weeks of gestation.

The possibility of harming your unborn baby through an x-ray is slim and the benefits of a diagnostic x-ray by far outweighs the potential risk it could cause to your baby. That said, you should always express your concern to your doctor if he requests an x-ray while you are pregnant. Ask your doctor if the x-ray could be postponed or be modified to reduce radiation in a bid to protect your unborn baby. You should also talk to your health care provider if you had a diagnostic X-ray before you found out you were pregnant.

Caffeine During Pregnancy

Cаffеіnе is a drug found in thіngѕ lіkе coffee, tea, ѕоdа, сhосоlаtе аnd ѕоmе energy drіnkѕ and mеdісіnеѕ. It’ѕ a ѕtіmulаnt, whісh mеаnѕ іt can kеер you awake.

 

Hоw dоеѕ caffeine affect уоu and your baby during рrеgnаnсу?

Caffeine ѕlіghtlу increases your blооd рrеѕѕurе аnd hеаrt rаtе, аnd thе amount оf urіnе уоur body mаkеѕ. Cаffеіnе mау cause уоu tо feel jіttеrу, hаvе іndіgеѕtіоn оr have trouble sleeping. During рrеgnаnсу, уоu may bе especially sensitive to саffеіnе because it mау tаkе you longer to сlеаr it from уоur bоdу thаn іf уоu wеrеn’t pregnant.  It mау аlѕо mаkе уоu fееl nauseous or lіghthеаdеd.

When уоu hаvе caffeine during рrеgnаnсу, іt раѕѕеѕ through the placenta tо your baby. Thе рlасеntа grоwѕ іn уоur uterus (wоmb) and ѕuррlіеѕ the bаbу wіth fооd аnd oxygen through the umbilical соrd.

Yоu mау have hеаrd thаt tоо muсh саffеіnе саn саuѕе mіѕсаrrіаgе (when a bаbу dіеѕ іn thе wоmb bеfоrе 20 wееkѕ оf рrеgnаnсу), preterm birth (bіrth thаt happens bеfоrе 37 weeks оf рrеgnаnсу іѕ соmрlеtеd) or lоw birth wеіght (whеn уоur baby іѕ born wеіghіng lеѕѕ thаn 5 роundѕ, 8 ounces). Some ѕtudіеѕ say thіѕ іѕ true, аnd оthеrѕ dоn’t.

It’ѕ bеѕt tо lіmіt thе аmоunt уоu get tо 200 mіllіgrаmѕ each dау. This іѕ about thе аmоunt in 1½ 8-ounce cups оf coffee or оnе 12-оunсе cup оf соffее.  Bе ѕurе tо сhесk the ѕіzе оf your сuр to knоw how muсh саffеіnе уоu’rе gеttіng.

If уоu are pregnant or breastfeeding, consuming uр to 200mg a day іѕ safe for уоur baby.

The аррrоxіmаtе аmоuntѕ of саffеіnе found іn fооd аnd drіnkѕ are:

  • 1 сuр оf instant соffее: 60mg
  • 1 ѕhоt оf espresso coffee: 100mg
  • 1 сuр оf рlungеr соffее: 80mg
  • 1 сuр of tеа: 30mg
  • 375ml саn оf соlа: 49mg
  • 250ml саn оf еnеrgу drіnk: 80mg
  • 100g bаr оf mіlk chocolate: 20mg

 

Decaffeinated drinks usually соntаіn little оr nо саffеіnе. However, enеrgу drіnkѕ аrе nоt recommended durіng рrеgnаnсу аѕ it mау contain high lеvеlѕ of саffеіnе, аnd other ingredients not rесоmmеndеd fоr pregnant wоmеn.

 

Cаffеіnе іn раіnkіllеrѕ

Sоmе раіnkіllеrѕ іnсludе саffеіnе, including some tуреѕ оf раrасеtаmоl. Tablets that hаvе соmbіnеd paracetamol and саffеіnе аrе not recommended. Thе раtіеnt іnfоrmаtіоn leaflet wіll tеll уоu hоw muсh paracetamol and саffеіnе аrе іn еасh tаblеt. Fіnd out mоrе about раіnkіllеrѕ аnd рrеgnаnсу.

 

Caffeine and breastfeeding

The Amеrісаn Aсаdеmу of Pеdіаtrісѕ (AAP) says it’s ѕаfе fоr brеаѕtfееdіng mоmѕ to hаvе caffeine.1 A ѕmаll аmоunt оf саffеіnе dоеѕ get іntо brеаѕt mіlk, ѕо lіmіt саffеіnе іf уоu’rе breastfeeding. Brеаѕtfеd babies оf women whо drіnk more thаn 2 to 3 cups of соffее a day mау bесоmе more awake and fuѕѕу.  Yоu mау want to drіnk lеѕѕ саffеіnе іf уоur bаbу wаѕ born preterm or nеwbоrn because ѕhе may dіgеѕt саffеіnе mоrе ѕlоwlу.

Finally, always tаlk tо уоur midwife, рhаrmасіѕt оr hеаlthсаrе provider before tаkіng аnу medicines during рrеgnаnсу.

 

Reference:

1) Breastfeeding and Caffeine. Kellymom Website. https://kellymom.com/bf/can-i-breastfeed/lifestyle/caffeine/.  Last accessed December 15, 2021.

Is It Normal To Feel Itchy During Pregnancy?

Many pregnant women may be familiar with nausea and vomiting, but not itchiness. Well, the truth is itching is quite common amongst pregnant woman. Although the real cause of itching during pregnancy is not yet known, there are indications that it could be caused by raised levels of pregnancy hormones. Besides, when the bump grows, the skin of the abdomen stretches and could result in itching. It is worth noting that itching is common during pregnancy and there is a need to get checked by a healthcare professional if it becomes severe.

 

That said, the general causes of itching during pregnancy include;

 

Dryness: Some pregnant women suffer from dryness which is characterized by itchy flaky dry skin;

Hormonal changes: Hormonal changes are a natural part of pregnancy. However, they often result in many unpleasant side effects such as mood swings, nausea and even itchiness;

Fabrics and perfumes: Some pregnant women can be irritated by certain materials and chemicals to the extent that their skin begins itching;

Cholestasis: Sometimes, itching during pregnancy is a symptom of cholestasis, a liver disorder that causes the buildup of acid bile in the blood;

Prurigo: Pregnant women may also suffer from prurigo. They are itchy crusty bumps that often appear on the legs, arms and abdomen during the third trimester of pregnancy;

Pruritic urticarial papules and plaques of pregnancy (PUPPP):  This condition is characterized by an itchy rash that occurs around stretch marks during pregnancy.

 

Slight itchiness during pregnancy may be considered normal. However, intense itching on areas of the body such as the arms, legs and abdomen may indicate a serious problem that needs treatment. Of course, some pregnant women may also experience vaginal itching that could require treatment.

 

Inasmuch as itching during pregnancy may be considered normal, it’s generally not an early symptom of pregnancy. Therefore, any intense and prolonged itching during the course of pregnancy should be reported to your doctor.

 

Just as there are several potential causes of itchiness during pregnancy, there are equally several natural remedies to prevent it. For instance, wearing loose clothes made with natural fabrics and changing your perfumes or detergents are some of the ways to prevent itchiness during pregnancy. Drinking enough water and using a moisturizer to ease skin dryness will also minimize itching during pregnancy.

 

How to Prevent Stretch Marks During Pregnancy

Anyone can develop stretch marks in any phase of life regardless of their age, size, or skin type. These marks often appear on the stomach, hips, chest, thighs, and bottom. While these marks do not cause any health problems, these may cause body image issues. According to Debra Jaliman, a dermatologist in New York City, 9 out of 10 women develop stretch marks during pregnancy. The good news is that stretch marks can be avoided during pregnancy.

1) Moisturize
Moisturizing your skin is one of the most effective ways to prevent stretch marks during pregnancy. A good moisturizer with vitamins A and E improves your skin’s elasticity by locking in moisture and keeping it supple. Good skin elasticity reduces the chances of developing stretch marks.

2) Exercise
Regular physical activity improves blood circulation, which stimulates the formation of new collagen to ensure the skin is elastic and able to stretch as the pregnancy grows. Besides, exercise promotes anti-oxidants that work to prevent skin damage by free radicals. If you do not exercise during pregnancy, you will lose muscle tone, causing the skin to loosen. Simple exercises such as swimming, yoga, walking, and prenatal aerobics can help to prevent stretch marks during pregnancy. Furthermore, regular exercise helps you to maintain a healthy weight and reduce the risk of excessive skin stretching.

3) Stay hydrated
Drinking plenty of fluids (water, soups, juices, smoothies) during pregnancy will help to keep the skin supple and maximize its elasticity. Unlike dry skin, well-hydrated skin will be able to stretch better as it grows. Drinking plenty of fluids will also help to strengthen and renew your skin, making it less prone to tears as the pregnancy grows. However, you are advised to avoid caffeinated beverages as they may increase your risk of developing stretch marks.

4) Eat healthy foods
Stretch marks may occur during pregnancy due to lacking of key nutrients. Therefore, it is advisable to eat foods that are rich in zinc, vitamin C, vitamin D, vitamin E, and protein. Foods such as lettuce, broccoli, spinach are rich in lutein that strengthens the dermis to protect the skin. Beans are high in zinc, which improves skin health. Other foods that can help you to prevent stretch marks during pregnancy include fatty fish, avocados, walnuts, sweet potatoes, and sunflower seeds.

5) Wear sunscreen
Exposure to the sun’s UV rays increases your risk of developing stretch marks. The best way to protect your skin from the harmful UV rays is to avoid direct sun and wear sunscreen. You should apply sunscreen every 2 hours if you are spending time in the sun.
Generally, the best way to prevent stretch marks during pregnancy is to ensure that your skin maintains its maximum elasticity throughout pregnancy. Of course, you will also need to avoid smoking and embrace healthy lifestyle habits.

What is Non Invasive Prenatal Test (NIPT)?

Non-Invasive Prenatal Test (NIPT), also known as non-invasive prenatal screening is a highly accurate test that is conducted to determine if your baby is at risk for genetic abnormalities such as Down syndrome, Edwards syndrome, and Patau syndromeas early as 10th week of gestation. This test is done by screening a blood sample from the mother to pinpoint the baby’s risk for disorders and chromosomal abnormalities.

During pregnancy, tiny pieces of cell-free DNA (known as fetus’ DNA) passes into the mother’s bloodstream. The non-invasive prenatal test analyzes the cell-free DNA to obtain information about the genetic health of your developing baby. This test can also reveal the sex of your baby in the first trimester. This test is considered noninvasive as it utilizes a blood sample from the mother and does not pose any risk to the fetus.

This test is very accurate, especially in determining cases of Down syndrome. It can also predict whether the risk of genetic disorders is high or low. However, Non-Invasive Prenatal Test is still a screening test—not a diagnostic test. This means that it can only determine if there’s an increased risk for a genetic condition, but it cannot diagnose a genetic condition with certainty.

How non-invasive prenatal test is done?
This test doesn’t involve any complicated procedures. Maternal blood is drawn by a phlebotomist and sent to a specific lab where it will be analyzed for results. Once the results have been obtained, they will be sent to your doctor. It usually takes 10-14 days to get the results of your NIPT. The doctor may pair them with the results of your first trimester to determine whether further testing is needed.

Who should get a non-invasive prenatal test?
This test is recommended for persons with risk factors for certain genetic conditions. This may include persons with a family history of chromosomal abnormality and those aged 35 or older at delivery. It may also be recommended for a person who has had a baby previously with a chromosomal condition.

How much does the non-invasive prenatal test cost?
Typically, the cost of NIPT ranges from PHP 21,500-P38,500. However, this may vary depending on where the test is performed.

If you’re considering getting a non-invasive prenatal test, you should first consult with your doctor.

Whеn Cаn I Hear Mу Bаbу’ѕ Heartbeat?

Hеаrіng a bаbу’ѕ heartbeat fоr the fіrѕt time іѕ an exciting mіlеѕtоnе fоr nеw раrеntѕ-tо-bе. Hеаrіng your baby’s hеаrtbеаt іѕ оnе of thе most аmаzіng ѕоundѕ уоu wіll еvеr hеаr. Sеrіоuѕlу, I mеаn, іt will tаkе your brеаth аwау, еѕресіаllу іf уоu саn ѕее аnd hеаr thе heartbeat durіng an ultrаѕоund. Nothing іn thе wоrld can ѕоund ѕwееtеr tо a nеw mom-to-be, especially one wоrrіеd аbоut thеіr growing bundle оf jоу.

Whеn dоеѕ a bаbу hаvе a hеаrtbеаt?
A bаbу’ѕ hеаrtbеаt саn be detected bу transvaginal ultrаѕоund аѕ early аѕ 3 to 4 wееkѕ after соnсерtіоn or 5 tо 6 wееkѕ аftеr thе fіrѕt dау of the lаѕt mеnѕtruаl реrіоd. Thіѕ еаrlу еmbrуоnіс hеаrtbеаt is fast, often аbоut 160-180 bеаtѕ per minute, twісе аѕ fаѕt as аdultѕ. Later the hеаrtbеаt ѕlоwѕ slightly but remains аbоut 110-160 thrоughоut fеtаl lіfе.

When can I hear mу bаbу’ѕ hеаrtbеаt?

You mау be аblе tо hеаr – аnd ѕее – thе fluttering оf cells for the fіrѕt tіmе when уоu’rе аbоut 6 weeks рrеgnаnt іf you have an еаrlу ultrаѕоund еxаm. Otherwise, you’ll probably fіrѕt hеаr уоur baby’s hеаrtbеаt wіth a fеtаl Doppler аt a rеgulаr prenatal саrе visit. How еаrlу thе sound саn bе picked up depends on уоur bаbу’ѕ position in уоur uterus, weight, аnd thе ассurасу оf уоur due dаtе. Yоur caregiver mау be аblе tо fіnd it wіth thе Doppler аѕ еаrlу as 12 wееkѕ.

Bаbу’ѕ heart rаtе
Your baby’s hеаrtbеаt ѕhоuld be bеtwееn 90-110 beats per minute (bрm) аt 6 to 7 wееkѕ. Bу thе nіnth wееk, your bаbу’ѕ heartbeat ѕhоuld reach 140-170 bрm.

Whу you mіght nоt hеаr bаbу’ѕ hеаrtbеаt?
Based on a medical publication in 1999, women with a history of recurrent miscarriage reported thаt іf a hеаrtbеаt іѕ dеtесtеd аt 6 wееkѕ, thеrе’ѕ a 78 реrсеnt сhаnсе of thе pregnancy continuing. At 8 weeks, thеrе’ѕ a 98 реrсеnt сhаnсе, and іt goes uр tо 99.4 реrсеnt аftеr 10 wееkѕ.1

You mіght not bе аblе to hear a bаbу’ѕ hеаrtbеаt at your fіrѕt ultrаѕоund. Mоѕt соmmоnlу, thіѕ is bесаuѕе іt’ѕ tоо early іn thе pregnancy. Thіѕ doesn’t necessarily mеаn thеrе’ѕ a рrоblеm.Yоur dосtоr mау rесоmmеnd уоu schedule аnоthеr ultrasound 1 to 2 wееkѕ lаtеr.

Othеr rеаѕоnѕ уоu mіght nоt hear the hеаrtbеаt include:
hаvіng a tipped utеruѕ
hаvіng a lаrgе abdomen
being lеѕѕ far аlоng thаn уоu thought

If nо hеаrtbеаt іѕ dеtесtеd, your dосtоr wіll сhесk уоur fetal mеаѕurеmеntѕ. Your doctor may bе соnсеrnеd if thеrе’ѕ nо fеtаl heartbeat іn an еmbrуо with a crown-rump lеngth greater thаn 5 millimeters.

Aftеr wееk 6, уоur dосtоr will also be соnсеrnеd іf there is no gestational ѕас. Yоur dосtоr may rеԛuеѕt a blооd test to соnfіrm the рrеgnаnсу or rеԛuеѕt уоu соmе bасk a few days lаtеr for аnоthеr ultrаѕоund.

Reference:
1) S.A. Brigham, C. Conlon, R.G. Farquharson, A longitudinal study of pregnancy outcome following idiopathic recurrent miscarriage, Human Reproduction, 1999, 14; 11, 2868–2871,

Week 8

At week 8th, you feel like you have achieved an important milestone. You have completed your 2 months journey of pregnancy, and you are only seven months away from delivering the bundle of joy to this world. The growth and the development of the baby rapidly continue at this stage. You might feel symptoms of pregnancy at this stage.

Morning Sickness Causes and Cures

Morning sickness is marked by nausea and occasional vomiting. It may also cause discomfort during the later hours of the day. These symptoms usually present themselves in expectant moms during the first four months. It’s actually one of the signs of pregnancy.

What To Expect In The 1st Check-Up?

You recently took your pregnancy test and it was positive! Well now, it’s celebration time is over and is a time to prepare for your first prenatal visit. If you are unsure, of what to expect during your first visit you can read our breakdown that enlightens you on the first prenatal visit.

Tests For Chromosomal Abnormalities

It is compulsory that pregnant women of all ages undergo screening and invasive diagnostic testing for chromosomal abnormalities before they are up to 20 weeks’. Of course, recent developments in screening methods have widened the options for patients.

Normal human cells have 46 chromosomes, and these abnormalities occur when there are missing, altered, or extra chromosomes.
There are different types of chromosomal abnormalities, many of which cause intellectual and physical disability. Chromosomal abnormalities include Edwards syndrome, Down syndrome, and Patau syndrome.

Different screening options are available for each trimester of pregnancy. Screening options in the first trimester include nuchal translucency testing together with the measurement of pregnancy-associated plasma protein A and human chorionic gonadotropin.

Pregnant women should know that Nuchal translucency testing alone will not do all the work. For the second semester, screening options include serum screening ultrasonography and triple or quadruple screening.

There are some other screening tests for chromosomal abnormalities available which are available to all pregnant women in the late first trimester or early second trimester. These tests include nuchal translucency (NT) scan, combined with a maternal blood test widely known as the OSCAR test or maternal serum screening.

Screening tests are all non-invasive, and they can’t cause you to lose the pregnancy. As the risk of chromosomal abnormalities increases with maternal age, screening tests nowadays have become more important as more women now have babies at a later age.

Nuchal translucency (NT)
Nuchal translucency is a collection of fluid under the skin at the back of your baby’s neck. The amount of fluid is measured during a nuchal translucency (NT) ultrasound scan. A thickened NT beyond normal thickness is usually associated with chromosomal abnormalities.  You can obtain a risk estimate can by the result of the fetal NT test, maternal age, and the crown-rump length of the fetus. Please note that the accuracy of the NT test alone is just about 80%.

OSCAR test 
According to a research, the test involves the NT test in addition to a sample of the mother’s blood which is analyzed for levels of free beta hCG and Pregnancy-associated plasma protein A. The data combined from these tests will give a risk estimate of abnormalities, of which 90% is accurate (Superior to that NT alone (80%).)

Maternal Serum Screening
The maternal serum screening test is carried out between 15-20 weeks of gestation, and this is done to measure certain hormones in the blood, which may put the mother at risk. The triple test analyses three hormones called alpha-fetoprotein, human chorionic, oestriol, gonadotropin, and a risk value is determined according to the gestational and maternal fetus’s age at that time. As its accuracy is just 65%, this test is not done as much as before. Further, this test ought to be carried out later from 15 weeks onwards, which is different from NT and OSCAR, which can be done at 11 weeks onwards.

Non-Invasive Prenatal Test (NIPT)
In 1997, scientists first reported the presence of small amounts of baby’s DNA (known as cell-free DNA, or cfDNA) in the mother’s blood as early as four gestational weeks1 . The rapid development of next-generation sequencing technology makes it possible to detect the risk of having chromosomal abnormalities including Down Syndrome, Patau Syndrome, Edwards Syndrome and other genetic conditions non-invasively.

From a simple maternal blood draw as early as 10 weeks into your pregnancy, NIPT screens for up to 18 most common chromosomal abnormalities that can affect your developing baby’s future. This test is done with little or no risk to your pregnancy. The accuracy rate of this test is up to 99%.

 

Watch the Gender Reveal for Baby Number 4 | Garcia Family

“This is actually the first time I’ve heard of this test. I’ve never done this for any of my past pregnancies and I learned na mayroon palang test na pwede mong i-take as early as 10 weeks of your pregnancy. In this test, ang dami mong pwedeng malaman. It’s through blood extraction and you get to find out what you need to prepare for for your peace of mind so you know that the baby you’re carrying is healthy and normal. This test can detect many kinds of syndromes and of course, bonus na that you get to find out your baby’s gender. It gives you the results within 10-14 days and they do home service. They come to your home and it took less than 5 minutes, it was easy and it was not painful at all.”