Right From the Start LTD.

 During pregnancy and lactation you'll need to drink 8-12 eight ounce glasses of liquids every day. Water is essential to life providing a route of transmission for nutrients and cells, balancing acids, holding salts, and cushioning the body's cells and organs. Water contributes 55-65% of the adult body weight. During pregnancy and lactation, your body's water compartments grow substantially. The fetus also requires a rich fluid supply to grow, develop and live comfortably in its prenatal environment.

Water needs can very substantially from person-to-person and environment-to-environment. Pregnancy and lactation, exercise, hot environmental temperatures, dry climates and high fiber diets all increase needs. Inadequate water consumption can lead to fatigue, muscle weakness, and decreased mental alertness in pregnant women. To the fetus it can mean inadequate nutrient transport, poor waste product removal, an excessively warm maternal environment and insufficient fluid in its amniotic sac. All these effects of dehydration jeopardize fetal growth and development, and in some women can bring about preterm labor and delivery. 

 Word of the Month...Amniotic fluid index (AFI)

...is a measure of the amount ofamniotic fluid and is an index for the fetal wellbeing. It is a part of the biophysical profile.

AFI is the score given to the amount of amniotic fluid (by adding up centimeters of depth of four pockets of fluid) seen on pregnant uterus by ultrasound.

An AFI < 5-6 is considered as Oligohydramnios and an AFI > 20-24 is considered as Polyhydramnios.

In most cases during the hot and humid summer months you will spend your time wondering if your air conditioner is actually working - because no matter what you set the temperature at you just won’t seem to be able to cool down.

Tips for a healthy and cool summer

*If you do have chores or tasks you need to do outdoors - do them in the morning or evening when it is cooler.
*When temperatures go above 90F - make sure you stay indoors and close to the fan or air conditioner.
*Wear light-colored and light fabric clothing. Don't even go anywhere near skin tight clothes!
*Keep yourself well hydrated by drinking plenty of liquid. You can also replace lost electrolytes and salts by drinking some sports drinks - but don't overdo them.
*Carry a spray bottle of water with you at all times.
*Apply sunscreen with an SPF of 15 or higher 20 minutes before going into sun -- reapply throughout the day.
*If you need to cool down, then taking a cool shower will do the trick. If you do have access to a pool - you could take cooling dips to help stay cool. Try and avoid being in the pool during the hottest parts of the day though!
*Feet and ankles swollen all the time? Then keep you feet up to help alleviate swelling.
*If you want to minimize water retention and bloating then you should try  minimize your salt intake.
*Take frequent naps.
*Ask for help! You will definitely have less energy during the summer months, so don't be afraid to ask for help if you are finding it difficult to cook, clean or run errands.
*Beware of typical barbecue foods such as potato salad and coleslaw that, when left out in the sun, can sour and cause stomach upset.
*Your skin is generally more susceptible to skin damage while you are pregnant and so the summer months will put even more stress and strain on your skin - making it more prone to damage.

Deal With Heat Rash
Miliaria, or prickly heat rash, can be caused by both heat and sweat and typically occurs where two skin surfaces have touched or rubbed - such as under your breasts or between your thighs. You can help to prevent this from happening by keeping these sort or areas dry, so when you get out of the shower or bath, make sure that you keep these areas, or other areas where skin rubs, dry. If you do develop a rash, then speak to your healthcare provider about what lotion or powder is best to use.

Dry, Itchy Skin
Dry skin is common during pregnancy and will often lead to itchy skin as well. You can prevent itchy skin during the summer months by using moisturizing shower products and applying lotions immediately following a shower or bath.

Patches and Dark Spots
The mask of pregnancy is fairly common to many women. This is usually caused by the change of hormones over the course of their pregnancy. It is especially common among brunettes and darker-skin toned women. You can help prevent melasma from happening - or getting worse - by keeping your face and upper chest away from tanning lamps and excessive sunlight.

Remember, if you do go out into the summer sunlight be sure to apply plenty of sunscreen before hand.

click on book above to go to Fan page

Worried that you—or someone you love—might be suffering from postpartum depression? This understanding, authoritative guide explains this sensitive disorder and how it differs from the “baby blues.” You’ll see how to find the right doctors, evaluate the various treatments—from medication to acupuncture to therapy and self-help groups—and create a comprehensive plan for recovery.

Author: Dr. Shoshana S. Bennett

The facebook fan page for this book will be doing a group book discussion online. If you are looking for information on postpartum depression join this group!. Dr. Shosh herself will be answering questions along the way!

Taken from WABA's Press Release

1-7 August 2009

In Emergencies, Breastfeeding Is A Lifeline.

Emergencies can happen anywhere in the world. Infants and young children are

especially vulnerable to malnutrition, illness, and death in these situations.

Whatever the emergency –from earthquake to conflict, from floods to the flu pandemic – the story is the same: breastfeeding is a lifeline and a shield that protects infants in emergencies.

From 1-7 August 2009, the World Alliance for Breastfeeding Action (WABA), and breastfeeding advocates in more than 150 countries worldwide will be celebrating World Breastfeeding Week (WBW) for the 18th year. This year, WABA teams up with the Emergency Nutrition Network (ENN) and the International Baby Food Action Network-Geneva Infant Feeding Association (IBFAN-GIFA) who represent an international collaboration of United Nations agencies and non-governmental organisations (IFE Core Group) concerned with protection and support of safe and appropriate infant and young child feeding in emergencies. Together we call for the active protection and support of breastfeeding during emergencies and the prevention and refusal of donations of breastmilk substitutes1, bottles and teats that, too often, do more harm than good. When an emergency strikes, simple measures can make all the difference in the world. Emergency preparedness is the key to quick appropriate actions. Mothers need to be secure and have priority access to food for the family, water, shelter and safe places to breastfeed.

The World Health Organisation (WHO) and UNICEF recommendations - early initiation and exclusive breastfeeding until six months of age and continued breastfeeding for two years or beyond - are even more critical in emergencies. Breastfeeding is the one safe and secure source of food and fluid for infants - instantly available, providing active protection against illness and keeping an infant warm and close to his/her mother. It also reduces the risk of post-partum haemorrhage in the mother, the leading cause of maternal mortality worldwide. In the challenging and risky environment of an emergency, how infants are fed is key to their survival. Protecting breastfeeding and infant and young child feeding from inappropriate marketing influences is an essential component of emergency interventions. Violations of the International Code of Marketing of Breastmilk Substitutes and subsequent relevant WHA Resolutions are frequent2. International guidance3 developed by the IFE Group clearly states that donations of breastmilk substitutes, bottles and teats should not be sought nor accepted in emergencies.

Everyone can play a positive and important role in emergency preparedness and response. Find out what you can do by consulting the WBW 2009 ACTION FOLDER produced by WABA and the IFE Core Group that includes an extensive Guide for Action. Available online at the WABA website and in print in 4 languages from WABA.

‘Breastfeeding is a vital emergency response.

When a disaster strikes, everyone should be ready!’

1 Breastmilk substitutes include infant formula, other milks, infant foods, juices, teas

2 As documented in IBFAN-ICDC Focus May 2009 publication on ‘The Code and Infant feeding in emergencies’

3 Operational Guidance of Infant and Young Child Feeding in Emergencies, version 2.1, February 2007. ww.ennonline.net

For further information:

1) Julianna Lim Abdullah International WBW Coordinator

Tel: (604) 658 4816

Fax: (604) 657 2655

Email: wbw@waba.org.my

Immunization is a subject that evokes very strong opinions and usually stirs up heated debate as to their efficacy, safety, and reliability.  The main questions parents have to answer are whether to immunize or not, and if so, when and with which ones.

It is vital that doctors educate their patients as to the pros and cons, indications and contraindications, and risks and benefits of vaccinations in order that the parents can then make an informed choice for their children.  By providing a balanced view of the evidence on immunization, naturopathic physicians and other health care providers can help people make intelligent decisions regarding their health care, and the health care of their dependents.

The basic idea behind immunization is to produce a state of immunity to these childhood infectious diseases through the deliberate, artificial stimulation of the body's defenses against each disease.  Ideally, this is done without causing any symptoms or signs of illness.

Common Types of Vaccination

DPT (Diphtheria, Pertussis, Tetanus)

This is most commonly used in combination as a trivalent mixture of diphtheria toxoid, tetanus toxoid, and pertussis vaccine.  It is also used as a bivalent mixture of diphtheria toxoid and tetanus toxoid.

Diptheria

This is caused by Corynbacterium diphtheriae and is a rare disease today, with less than 100 cases reported annually in the U.S.  Diphtheria toxoid for the vaccination is prepared by formaldehyde detoxification of highly purified diphtheria toxin.  Children under 7 years of age receive 4 doses according to the adopted schedule.  There are really no contraindications unless one has a previous reaction to the agent.  There may be tenderness, edema, and erythema at the injection site and a low-grade fever for a few days following the vaccine.  Passive immunity from the mother lasts about six months, and longer in the breast-fed infant.

Pertussis (Whooping Cough)

This is caused by Bordatella pertussis, with about 2,000 cases reported annually in the U.S.  Pertussis vaccine is a killed whole-cell preparation of a culture of Bordatella pertussis.  A series of four doses is given for basic immunization, with a booster recommended between ages 4 and 6, according to the adopted schedule.  Newborns are susceptible in spite of maternal immunity.

This vaccine is not recommended after age 6 due to the increased risk of side effects.  Contradictions include neurological disorders of unknown status.  Side effects include screaming episodes and prolonged, unresponsive crying, fever of 105 or greater, convulsion with or without fever, collapse, encephalopathy, and local inflammatory changes at the site of injection.

Tetanus

Clostridium tetani produces a potent neurotoxin, which, under anaerobic conditions, produces the disease known as lockjaw.  There are approximately 100 cases reported annually in the U.S., with a 40% fatality rate.  Immunity to tetanus results from immunizing agents only;  the disease does not confer immunity.  A newborn infant is immune if the mother is properly immunized.

The tetanus toxoid is a formaldehyde-immunity, with a reinforcing dose every 10 years.  The only contraindication is a severe prior reaction to the toxoid.  There may be mild inflammation at the site of injection.

Poliomyelitis

There are about 20 cases of polio reported annually in the U.S.  Vaccines used according to the established guidelines can be protective, with three separate doses given by age 2, and a booster given at about age 5.

Two types of polio vaccine are available in the U.S.:

1. Oral polio vaccine (OPV), a live, attenuated virus agent;  and

2. Inactivated polio vaccine (TOPV), a mixture of all three types of the virus, which is recommended for those under age 18.

Contraindications include immune deficiency diseases, altered immune status, use of steroids, alkylating agents and antemetabolites, and pregnancy.

MMR (measles, mumps, rubella)

This is often given as a trivalent vaccine at 15 months of age, although each one can be used separately.

Measles (Rubeola)

The measles vaccine is a highly attenuated strain of rubella virus.  Duration of immunity is not known, although the vaccine is good for at least 15 years.  The disease itself, if contracted, offers lifetime immunity.  Vaccination is recommended at age 15 months for all susceptible individuals.

Contraindications include acute febrile illness, immunodeficiency diseases, pregnancy, malignancy, and use of immunosuppressive drugs.  Side effects of the vaccine include moderate fever and skin rash.

Mumps

The mumps vaccine is a preparation of a live attenuated strain of mumps virus.  Mumps is usually a self-limited disease, and if contracted, offers lifetime immunity.  Duration of vaccine-induced immunity is unknown, but it does offer protection for at least 12 years.  Mumps rarely results in permanent dysfunction, but can cause unilateral nerve deafness and can cause mumps orchitis in postpubertal males.  Maternal antibodies protect up to about age 12 months.

Mumps vaccine is contraindicated in persons with malignancy, immune deficiency disease, conditions of altered immunity, and in pregnancy.  Side effects to the vaccine are usually limited to local mild inflammation at the site of injection.

In reality, no immunizing biological agent is completely safe, and it may produce side effects.  It is important to assess each individual child and each individual vaccine, and then allow the parent to decide what to do after weighing all the facts and sorting out the fiction.

Ask for help!!