More often than not, lactation is associated with pregnancy, breastfeeding, and the mother’s body preparing to care for the newborn baby. Though many times the mother’s body will produce milk on its own, sometimes the mother needs to receive additional help to produce enough milk for breastfeeding. Additionally, it is also possible to receive extended hormonal treatment for induced lactation. A small percentage of women can also begin lactating without any association to pregnancy—a condition known as galactorrhea where excessive milk is produced.
Natural Lactation
The mother’s body prepares to lactate in the final months of pregnancy, and it does so through three main hormones: estrogen, progesterone and placental lactogen. Especially at the time of delivery, the hormone prolactin levels increase to such an extent so as to initiate milk production, while at the same time the levels of estrogen and progesterone decrease. According to the CDC, the American Association of Pediatrics suggests that infants should be continuously breastfed during the first six months of their lives, while other foods are gradually introduced. It is also recommended that breastfeeding continues at intervals until about two years of age, but most infants are neither exclusively breastfed nor do they continue to breastfeed for as long as recommended.
Induced Lactation
Many mothers need to replicate the body’s process of milk production to either enhance the lactation process, or to recreate it because they are coming into motherhood without pregnancy. This is most common with mothers who wish to breastfeed their adopted baby. To achieve induced lactation hormone therapy is the first required step: supplemental estrogen or progesterone may be prescribed to mimic pregnancy, and it can last for months. A few months before the expected breastfeeding date, hormone therapy will cease and you will begin the process of pumping your breasts to encourage the release of prolactin. This is a lengthy process, and the pumping gradually increases in time and intensity. It is likely that in the case of induced lactation time may not be on your side, in which case other medications may be prescribed. However, what remains integral for the milk supply necessary for breastfeeding is the process of pumping.
Galactorrhea
A number of women begin lactating without any association to pregnancy, a condition known as galactorrhea. The most common symptom is one or both breasts producing excessive milk, while other symptoms may include random leaking from the nipples, enlargement of breast tissue, irregular periods, low sex drive, acne and headaches. In some cases the cause of this may be hard to find, but the general rule is that it happens due to hormone imbalances, or as a side effect of medications. Since the most common reason for milk production is increased levels of the hormone prolactin, galactorrhea may happen due to medications, underlying medical conditions, a tumor, or overstimulation of the nipples. As with any condition with various causes, how it can be treated depends on what is causing it and it is up to your healthcare provider to conduct the appropriate tests to pinpoint the cause.
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Whether your child is back at school in-person, hybrid or e-learning, getting your child to focus on distance learning can be challenging. Parents are expected to be more involved and support hybrid and distance learning. But, remember, it’s also challenging to children because they are being asked to participate and engage with new learning modalities. Without an effective plan, it can be easy for children to become disengaged, causing frustration for the entire family.
Here are some tips for helping your kids get and stay on track.
- Adjust your expectations—hybrid and distance learning are not going to be exactly like full-time, in-person classes. Being in front of a screen all day is both mentally and physically taxing. While high schoolers can do work for longer periods of time, younger children will need more breaks and time for play.
- Make a flexible schedule—synchronous sessions (real-time video sessions with their teachers) helps structure the day and keeps a schedule, but it also leads to screen burnout. The amount of synchronous learning varies by school district, but many children are doing some work asynchronously (on their own). Making a schedule and dedicating time for all classes will help with consistency, but being flexible is recommended. This means, allow children to power through a task if they are focused and engaged, however, be willing to give children breaks when they seem overwhelmed.
- Take physical exercise breaks—sitting in front of a screen all day is draining, so it may seem like the best break is sitting and not looking at a screen, but actually the best break is being active. While some research claims that it’s best to get 10 minutes of physical movement for every 50 minutes of being stationary, incorporating as few as two (15-20 minute) exercise breaks in the day will immensely help you and your kids focus. Exercise ideas include short walks, bike rides/stationary cycling, yoga/stretching videos, and free weights.
- Reduce distractions by cultivating an ideal setting—when designating workspace for your family, do your best to reduce noise or clutter. Consider playing instrumental music or nature sounds to drown out any distractions that could distract from learning. Designate each family member their own clean, hard surface workspace such as a desk, kitchen table, or even a folding table. The key is to spread out enough so everyone has their own space.
- Rely on a checklist—help your kids stay organized by using a check-list system. Consider doing it by hand rather than digitally. Whiteboards are a great idea. Get one per family member, so that everyone has to take some responsibility for their own work.
- Give positive feedback—children need reinforcement and they are likely getting less from their actual teachers in hybrid and distance learning situations. Be sure to give your kids positive reinforcement when they have done a good job.
Above all else, stay positive and keep moving forward. Change is inevitable. Do your best to be adaptable to better handle and adjust to changing learning situations.
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Menstruation and general health are intricately connected, and the patterns of a woman’s period can provide us with important information about their well-being. From the duration of the menstrual cycle, to its intensity and blood color, we can usually understand if our bodies are healthy or if something is off and requires further investigation. Though the absence or presence of periods is what usually alerts us to possible problems, the menstrual blood color can be an indicator of possible problems, as health conditions and hormonal changes affect the color and texture of period blood.
Different Colors of Menstrual Blood:
Bright Red
- We usually associate red blood with a normal period flow, and most of the times this is the case. Menstrual blood that is red is fresh blood, and at the start of the period it is this color; for some it remains red, while for others it turns brown in the later days of their period. However, bright red blood in between periods or when you do not expect it might indicate the presence of an STI or be cause for concern for other health issues associated with your uterine lining or cervix. Particular attention should be paid if that is combined with a heavy flow and longer periods, abnormal weight loss and pain in the lower back.
Dark Red or Brown
- Darker blood is not an immediate cause for concern, as many myths will have us believe. In reality, it is oxidized blood—or old blood—that has been in the uterus longer. It may appear at the beginning of a period as a remnant of the previous cycle, or at the end of a period as blood that had time to oxidize. The older the blood that is being discharged, the darker it will be: even if it appears closer to black, there is no cause for concern. If you are, however, experiencing abnormal symptoms on your own body, consult your doctor.
Black
- Like dark red or brown, black blood is old blood that has remained in the uterus a long time and has oxidized. As discussed above, it is no cause for concern as the sole symptom, though sometimes it may be a sign of a blockage inside the vagina. If that is the case, other symptoms of a blockage may include itching or swelling in the vaginal area, difficulty urinating, fever and foul-smelling discharge.
Remember that it is normal for your period blood to change colors in the duration of your period, as it does not always start from fresh blood. There may be old blood and uterine lining that needs to be shed, and that also usually results in blood clots or other discharge. If you suspect that the color of your period blood may be indicating a health issue for you, or you are experiencing concerning health symptoms during your period, always consult your healthcare provider or a health expert.
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Women deciding to give birth at an older age is nothing new, and the average maternal age in the last decade has risen from 21 to 26. Becoming a mother for the first time comes even later in life for women with a college degree and a career, as reported by the New York Times. In general, women in their 30s, or even 40s, who decide to become pregnant are faced with a number of myths regarding pregnancy and maternity. Myths based on health reasons thrive, as do myths around social standing and becoming a parent later in life.
Myth of Infertility
Though it is true that fertility declines after the age of 35, that does not make it impossible for women to conceive after that age, nor does it mean that every woman who becomes pregnant after 35 has used IVF. The difficulties may be more, but they can be addressed with preventive fertility care, a healthy lifestyle, and prenatal planning with the support of your doctor. Keep in mind that issues leading to infertility are not always age-related, such as endometriosis. Therefore, there is no need to jump to conclusions about pregnancy over 35 as the challenges may have nothing to do with a woman’s age, and we can never know the capabilities of each body.
Myth of Putting the Child at Risk
Similar to the issue of infertility, the rumor that children born to mothers over 35 may be autistic or be diagnosed with Down Syndrome is alive and well. However, there is no evidence that directly links the mother’s age to such issues; there may be a higher risk of carrying a healthy pregnancy to term, or a risk of augmented complications, but only 1% of the cases of children born with autism since the 1990s has been due to maternal age. As with any maternal age, the mother’s overall health, diet and well-being has more of an impact on the baby’s health and on her pregnancy than her age per se.
Myth of Selfishness
Many women who decide to prioritize their education and career over starting a family fresh out of college, or even fresh out of high school, are criticized as being selfish. Another perspective on this issue, however, shows us that women who have kids early on face major difficulties in the workplace—from lack of childcare to limited opportunities to advance—and as a result have more trouble supporting their families. On the other hand, women who start their families having established a career earn about double the income than younger mothers and the opportunity to better support their kids.
Myth of Not Being Around
In addition to all of the above, women who give birth at a later age face the criticism that they will either be too old when their child reaches important milestones in their life or that they will not be around at all. Motherhood seems to provide such vitality to women that in the Journal of Health and Social Behavior in March 2005 it was reported that women who become mothers in their 40s are four times as likely to live to be 100! Additionally, we should remember that there are really no guarantees of “being around” at any particular age, as not everything always depends on natural causes.
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The vast amount of online resources on healthy eating and living can be overwhelming. On average, women need between 1,600 and 2,400 calories per day. However, there is so much more involved than simply targeting a number. Healthy eating involves some basic principles for food selection.
- Whole foods: Choose whole ingredients over pre-made food, as processed foods contain added sugars. This means, opt for proteins, fruits, and veggies that are in their natural state. For example choose an apple over applesauce or apple juice. Consider adding honey and nuts to plain oatmeal instead of pre-packaged honey nut oatmeal. Remember, every choice adds up.
- Lean protein: Chicken, turkey, fish, eggs, beans, and tofu are great sources of protein with low calories. Avoid fattier meats such beef and bacon.
- Whole grains: Whenever possible choose brown rice over white rice and wheat bread over white bread. While white bread and rice may taste smoother, they lost many nutrients during the refining process.
In theory, this all sounds super easy. Of course, everyone knows chicken is healthier than beef, and we should all eat our veggies! However, so many people rely on packaged foods for convenience. Many women have families to also think about, so fast and convenient is important. Thus, we’ve put together a roundup of the best online resources to help you get started.
Meal prep: While it may sound like a ton of work, meal prepping doesn’t need to be an all-day affair. Check out 25 Healthy Meal Preps and Skinnytaste for numerous recipes to get started on meal prepping. Remember, even meal prepping just one meal per day (yogurt parfaits or overnight oats for breakfast, or hearty soup for lunch) will save you time and calories.
Time-saving dinners: Yes, it’s so very tempting to pick up Panera, Chipotle, or even Buffalo’s favorite, Mighty Taco, on your way home. It’s quick and your entire family will eat it. Eating out once a week isn’t too bad, but anymore than once and the calories will add up. Consider quick and healthy weeknight meals by opting for pre-cut proteins such as ground turkey and chicken breast tenderloins. Additionally, Buffalo-area grocery stores, such as Wegman’s and Dash’s, offer many options for pre-cut fruit and veggies. For fast dinner ideas, check out Cooking Light, Taste of Home, and Olive.
Helpful Apps: Even with making some changes in your diet with a focus on whole foods, lean protein, and whole grains, it may still be hard to find your ideal body weight. There are so many online resources and phone apps, but our favorites are MyFitnessPal and iTrackbites (similar to the Weight Watchers concept). Both are free (though you can update for a reasonable fee for a premium) and are easy to use. In addition, you can download the app to have quick access to log food on your phone.
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There are different schools of thought on how often you should visit your OBGYN, and though one side recommends that you pay your doctor a visit once a year, the other side suggests that such frequency may not be necessary. The common ground, however, is that the frequency of OBGYN visits should depend on your overall health, as well as your personal history with gynecological health matters. It also varies among women, as every woman has different needs, and of course depends on age as well.
Age
Here are some recommendations based on age that may help you determine how often you should see your OBGYN, and for what services:
- Younger than 21: Start building a relationship with your OBGYN to feel comfortable asking them any questions.
- 21-29: You should receive a General Women’s Wellness Exam that includes a Pap smear and a pelvic exam once a year.
- 30-65: It is suggested to have a pelvic exam every year, and a Pap smear every other year unless otherwise suggested by your doctor. You should also have an HPV test done at least every 5 years.
- 65 and older: As long as you have had no history of precancerous cells or cervical cancer, you do not need to have Pap smears done. If you have undergone hysterectomy you also do not need a Pap test unless you have had a reproductive cancer in the past.
Other Factors
Though a Pap smear or a pelvic exam may not be necessary every year, keep in mind that the frequency of your OBGYN visits depends on other health factors as well. For example, if you are noticing that your gynecological health is out of the ordinary—such as excessive bleeding, or too little bleeding, abnormal pain, vaginal pain or discomfort, changes in menstrual cycle—you should consult your doctor and schedule a visit even if you are not due for one.
You should also reconsider the frequency of your visits to your OBGYN if it is suggested by your primary physician, if your overall health needs attention, and depending on how sexually active you are. If you are not having a Pap smear and have no other worrisome symptoms, some schools of though suggest that having a pelvic exam done may not be necessary. However, you should remember that a pelvic exam, along with other tests, can detect ovarian cancer early and provides a screening for sexually transmitted infections.
Preventive Reasons
In addition to the age factor and other reasons you may, or may not, need to visit your OBGYN you should be aware of the following, which are preventive services:
- Anemia screening
- Contraception and prenatal care
- STIs and HIV screening
- Diabetes Screening
- UTI screening
- Breast Cancer genetic test and mammography
- Osteoporosis screening
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If you have heard the word “circumcision,” you would most probably know it is done in the newborn period of a boy’s life. It is not unlikely that older boys or adult men undergo this procedure for personal, cultural, or medical reasons. Circumcisions are undoubtedly a controversial issue and, in the majority of the Western World, the decision rests with the parents of the newborn boy. Most commonly, it is a procedure performed in the United States, Canada, the Middle East, Australia, and Africa. It is less common in Asia, Europe, and South America. Parents may choose to circumcise their son for a number of reasons, such as religious beliefs, hygienic concerns, or the belief that it benefits the boy’s health at all stages of his life.
Before making this decision, it is important to know some facts about circumcision and be aware of both the advantages and the potential risks. Overall, it seems that the advantages of male baby circumcision outweigh the negative effects—as the American Academy of Pediatrics Supports. Though it is an ancient religious procedure, it has been thoroughly researched and studied by medical professionals across the globe.
What is it?
Circumcisions are a surgical procedure that refers to the removal of the skin that covers the tip of the penis (also known as foreskin).
What are the advantages?
Some of the health benefits of circumcision include:
- Easier hygiene: the removal of the foreskin makes it easier to wash the penis. Although it enhances good genital hygiene, boys should be taught how to properly clean themselves regardless.
- Decreased risk of urinary tract infections: though the risk of UTIs in males is generally low, UTIs are more common in uncircumcised males.
- Decreased risk of contracting HIV and other sexual transmitted infections. Remember circumcision is not a preventative for STIs, but it does lower the risks of one.
- Prevention of penile problems: the foreskin on an uncircumcised penis can be difficult or impossible to retract, also referred to as phimosis. This can lead to inflammation of the head of the penis, something that circumcision helps prevent against.
- Lower risk of penile cancer: although this is a rare type of cancer, it is less common among circumcised men. In addition, the risks of cervical cancer are lower among the female partners of circumcised men.
What are some risks?
Serious complications associated with circumcision are extremely low, around 0.2%, and mostly associated with circumcisions occurring outside a hospital. Minor complications are about 3%. All risks are minimal when the procedure is carried out by a trained medical professional in a sterile setting.
Some rare complications may include:
- Bleeding at the time of the procedure
- Infection
- Pain
- Deformity to the penis, usually appearing at a later age
Remember you are not medically or legally required to circumcise your baby. If you choose to do it, consult with your doctor and make sure you are comfortable in your decision, as well as
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With the increased consumption of processed foods, we lose many of the nutrients necessary for our overall health. A large number of women turn to dietary supplements and multivitamins to make up for what they are not getting via their diet. The effort required for a healthy and balanced diet is sometimes too much to be accommodated through the rapid tempo of daily life, so even though women could get a lot of the necessary nutrients through food this is not always realistic. Vitamins, multivitamins and mineral supplements, are especially helpful for the following categories:
- Women who are or may become pregnant: to lower the risk of birth defects, pregnant women should have a daily intake of at least 400 micrograms of folic acid.
- Postmenopausal women: due to hormonal changes after menopause, women tend to lose bone density at a faster rate—especially when compared to men. Calcium and vitamin D are optimal to prevent osteoporosis, and they are not adequately provided through nutrition. A supplement that includes those, along with B-12 and weight exercises will help prevent osteoporosis and any associated health problems.
- Vegetarians: the consumption of plant products and vegetables may mean that women who follow a vegetarian diet are more in need of vitamins generally found in animal products. Most commonly, vitamins B-12 and B-2, as well as vitamin D lack in vegetarian, and especially vegan, diets.
Though it is easy to turn to dietary supplements and minerals to make up for the low levels of these vitamins in food, it is not impossible to make dietary choices that provide you with the necessary nutrients. These are some of the foods that contain important vitamins and minerals for your health, though you should always listen to your body and consult your health care provider if you make major dietary changes or are experiencing health challenges:
- Vitamin B9 (folic acid): spinach and other dark green leafy vegetables, oranges, pure orange juice, nuts, beans, chicken, lean beef, whole grains, and cereals with added folic acid
- Vitamin B-12: low-fat or fat-free milk, eggs, liver, poultry, clams, sardines, flounder, herring, blue cheese, and nutritional yeast. It may also be found in food that have B-12 added, such as cereal, fortified soy beverages, and veggie burgers.
- Vitamin D: tuna, salmon, and fortified foods
- Calcium: low-fat or fat-free yogurt, cheese, and milk. Dark green leafy vegetables and canned salmon make good sources of calcium as well. It’s found in calcium-added foods such as select soy beverages, 100% orange juice, tofu, and cereals.
- Iron: lean red meats and chicken, seafood, cereals/breads with added iron, oysters, beans, dark chocolate, liver, spinach, tofu, and canned tomatoes.
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When should a girl start seeing a gynecologist or obstetrician-gynecologist (OB/GYN)?
Even if you’re not sexually active, the American College of Obstetrics and Gynecology recommends that you go between the ages of 13 and 15, although any time after menstruation and before your eighteenth birthday is fine. If you’re sexually active, go as soon as possible!
And why should you go?
To have confidential discussions about sex, sexuality, menstruation, pregnancy prevention, sexually transmitted diseases—pretty heavy stuff. It may sound like it will be an incredibly awkward experience, but here’s some information that may set you at ease:
- The first appointment is mostly about talking. To begin, the doctor or nurse will ask you questions about your health and lifestyle. They’ll go over your health history, like how old you were when you got your period and if you have any problems with it. They’ll ask about your sexual history, whether you’re sexually active or just thinking about it—and if you are, what birth control you use. They’ll also discuss your lifestyle: do you smoke cigarettes? Do you drink alcohol? Do you take drugs? Do you practice sexual behaviors that might put you at risk for STDs?
- You probably won’t need an internal pelvic exam. Unless you’re sexually active or having a medical issue, your physical exam will be external. The doctor will examine your outside genital area, your abdominal area, and your breasts. She or he is just checking for visible abnormalities, tenderness or lumps in your breast tissue. You shouldn’t need a Pap smear until you’re 21. As for the dreaded stirrups? They’re only there so you have a place to rest your heels and be more comfortable when you’re lying on the exam table. Many practices cover them with something soft.
- If you do need an internal pelvic exam, relax! You may know that this is when the doctor will use a speculum, either metal or plastic, to hold your vagina open so she or he can see if everything looks normal and healthy. Don’t worry—the speculum they use for teenagers is about the size of a super tampon. This part of the exam can be uncomfortable, but it shouldn’t hurt. If it does, speak up! After removing the speculum, the gynecologist will feel inside of you with one hand and press on your abdomen with the other. She’s checking to see if your fallopian tubes, uterus, and ovaries are in the right position and whether they feel normal. If any part of this process hurts, let the doctor know. And throughout, do deep, slow breathing and let your legs relax as best you can.
Remember, your doctor has seen and heard everything.
There is probably nothing you could ask or discuss that your OB/GYN hasn’t dealt with before. And everything you talk about is confidential. So go ahead and ask questions about your anatomy, your period, birth control, different sexual practices and anything else you might be curious or concerned about.
At Chouchani, Sayegh and Bagnarello, we know how strange that first appointment can feel. We’ll do our best to make sure you feel at ease. Please give us a call when you’re ready to make that first appointment.
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