READ THIS! It could help save your baby's life!

Folic acid is a necessary element needed for correct neural tube development. It is part of the B-Complex Vitamins and is also called folate or folacin. It is present in many leafy, green vegetables, orange juice, dried beans, and peas. Normal recommended daily dosage for all woman of child bearing ages is 400 micrograms (0.4 miligrams).Taking more than 1 miligram of folic acid daily is not recommended for all woman, because folic acid can mask the symptoms of pernicious anemia (a B-12 deficiency) and makes diagnosis difficult.For woman who have had a child with a neural tube defect, it is recommended for them to take 4 to 5 miligrams of folic acid daily for 2 to 3 months prior to conception and until at least the 3rd month of pregnancy. Studies have shown that by taking folic acid "before" pregnancy, nearly 70% of all neural tube defects can be prevented.(Folic Acid can significantly reduce the risk of having a baby with a neural tube defect,but does not totally eliminate the possibility.)

It is difficult to get enough folic acid by diet alone. Cooking can also wash out some of the folate as it is water soluable. Folic that has been added to cereal's can be lost in the milk if it is not drank. In fact, in order to get 4 mgs of folic acid(the recommended dosage for those who have had a previous child with a NTD), you would need to drink 80 glasses of orange juice or have 100 servings of broccoli. In the United States, we now fortify many of our grain products, such as bread, to help prevent neural tube defects, but it is still important to take a daily vitamin containing folic acid!

Body Changes After Giving Birth

(Info. provided by babycenter.com)
*How much weight will I lose after having my baby?
You probably won't return to your pre-pregnancy weight for some time, but you will lose a significant amount of weight immediately after delivery. Subtracting one 7- to 8-pound baby, another pound or two of placenta, and another 2 pounds or so of blood and amniotic fluid leaves most new moms about 12 pounds lighter.

The weight keeps coming off, too. All the extra water that your cells retained during pregnancy, along with fluid from the extra blood you had in your pregnant body, will be looking for a way out. So you'll produce more urine than usual in the days after birth — an astounding 3 quarts a day — and you may notice yourself perspiring a lot, even while you sleep. By the end of the first week, you'll lose about 4 pounds of water weight. (The amount varies depending on how much water you retained during pregnancy.)

*How come I can't tell when I need to pee?
It's not uncommon to feel as if you don't have to pee much in the first day after you give birth, especially if you had a prolonged labor, a forceps or vacuum-assisted vaginal delivery, or an epidural. This is caused by your bladder becoming temporarily less sensitive. But with all the extra fluid your kidneys are processing, your bladder fills up rapidly, so it's essential for you to urinate frequently even if you don't have the urge to.

If too much urine accumulates in your bladder, you might have a hard time making it to the toilet without leaking. More important, though, your bladder could become over-distended. This can cause urinary problems and also makes it harder for your uterus to contract, leading to more afterpains and bleeding.

If you can't pee within a few hours after giving birth, a catheter will be put in your bladder to drain the urine. (If you deliver by c-section, you'll have a urinary catheter for the surgery and the following 12 hours or so.) Let the nurse know if you're having difficulty urinating or are only producing a small amount of urine when you pee. If your bladder gets too full, it can actually prevent you from being able to urinate.

*How long will it take for my uterus to shrink?
By the time you give birth, your uterus is about 15 times heavier (not including its contents!) and holds at least 500 times more than before you conceived. Within minutes after your baby is born, contractions cause your uterus to begin to shrink, clenching itself like a fist, its crisscrossed fibers tightening in the same way they do during labor. This may cause you to feel cramps known as afterpains.

For the first couple of days after birth, you can feel the top of your uterus at or a few finger widths below the level of your belly button. In a week your uterus weighs about a pound — half what it weighed at delivery. After two weeks it's down to a mere 11 ounces and located entirely within your pelvis. By four to six weeks, it's back to its normal pre-pregnancy weight of about 2 1/2 ounces. This process is called involution of the uterus.

*Why am I bleeding?
After your baby's born, cells that form the lining of the uterus begin to slough off. This results in a discharge called lochia that lasts for weeks. For the first two to four days, lochia contains a fair amount of blood, so it appears bright red and menstrual-like. It gradually gets lighter in color, turning pinkish, and finally fading to white or yellow-white, with the amount tapering off over time before it stops.

*What's going on with my breasts?
Hormonal changes after delivery prompt your breasts to start producing milk. When your baby nurses during the first few days after birth, he's getting colostrum, a thick yellowish substance that your breasts produced during pregnancy. His suckling triggers the release of the hormones prolactin, which stimulates milk production, and oxytocin, which causes the milk sacs and ducts to contract, propelling the milk to your nipples. (This is the so-called "letdown" reflex.)

If those first breastfeeding sessions cause some abdominal cramping, it's because oxytocin also triggers uterine contractions. Once your milk comes in, usually a few days after delivery, your breasts may get swollen and lumpy and feel tender and uncomfortably full. This is called engorgement, and it should subside in a day or two. Nursing your baby often is the best thing you can do for relief. In fact, frequent nursing right from the beginning sometimes prevents engorgement altogether.

Even if you're not breastfeeding, you'll begin to produce milk, and a few days after you give birth, your breasts will become engorged and feel swollen and uncomfortable. This discomfort may last a couple of days or so. In the meantime, wear a supportive bra around the clock and put cold packs on your breasts, which will ease the swelling and help inhibit milk production. (Be sure to cover the cold packs with cloth to protect your skin.) It can take several weeks for your milk to dry up completely

If you need to, you can take acetaminophen or ibuprofen for pain relief. If you're extremely uncomfortable, you can express just enough milk to make the situation more tolerable. This may prolong the process, however, because stimulating your nipples and emptying your breasts signals your body to make more milk. Avoid applying warmth to your breasts since this, too, can encourage milk production.

*Why am I losing my hair?
If your hair got thicker during your pregnancy, you may now start to shed it in handfuls. This happens to some new moms around one to four months after having their baby. Don't worry — you won't go bald. Just as high estrogen levels caused you to lose less hair during pregnancy, decreasing estrogen levels postpartum may cause you to shed more. It's replaced by new hair, though, and the shedding tapers off, so your hair should be back to normal within a year. On the bright side, if you suffered from excess facial and body hair during pregnancy (the result of an increase in hormones called androgens), you can expect to lose that hair three to six months after having your baby.

*What's going on with my skin?
Hormonal changes, stress, and the fatigue brought on by new parenthood may affect your skin along with the rest of your body. Some women who had perfectly clear skin during pregnancy will have more breakouts in the months following delivery. On the other hand, if you suffered from acne during pregnancy, particularly if it appeared for the first time or got worse, you may begin to see some improvement now.

If you have chloasma (darkened patches of skin on your lips, nose, cheeks, or forehead), it'll begin to fade in the months after giving birth and probably go away completely, as long as you protect your skin from the sun. Any stretch marks you developed will gradually become lighter in color, though they won't disappear altogether.

*Will my vagina and perineum ever get back to normal?
Once you give birth, the space inside your vagina will always be a little larger than it was before your first pregnancy. Right after delivery, the vagina remains stretched open and may be swollen and bruised. Over the next few days, any swelling you might have starts to go down, and your vagina begins to regain muscle tone. In the next few weeks, it will gradually get smaller. Doing Kegel exercises regularly helps restore muscle tone.

If you had an episiotomy or a tear, your perineum needs time to heal, so it's a good idea to wait until after your six-week postpartum checkup to resume having intercourse. You may even have some tenderness after that, too, so be sure to go slowly. Consider starting out being on top of your partner or lying side-by-side so you can control the depth of penetration. In any case, if you find intercourse painful, wait a little longer. (If you want to make love, you can figure out other ways in the meantime!)

When you start having sex again, you'll probably find that you have less vaginal lubrication that you did when you were pregnant, due to lower levels of estrogen. This dryness will be even more pronounced if you're breastfeeding, because nursing tends to keep estrogen levels down. Using a lubricant (usually found near the condoms or the tampons and sanitary pads in the drugstore) helps reduce any discomfort. Be sure to get a water-based lubricant. This is particularly important if you're using a barrier method for birth control, since oil-based lubricants can weaken latex and cause a condom to break.

*Why am I feeling so moody?
Hormonal dips and surges may contribute to any emotional swings you're feeling now, along with discomfort you're still experiencing from labor and birth, the physical demands of caring for a new baby, and the emotional adjustment to motherhood. Whatever the cause, it's common to feel a little blue, usually beginning a few days after giving birth and lasting for a few days. If the feeling doesn't go away on its own in the first few weeks or you find that you're feeling worse rather than better, be sure to call your caregiver. You may be suffering from postpartum depression, a more serious problem that requires treatment.

Morning Sickness: Causes, Concerns & Treatments

(provided by babycenter.com)


Why do they call it morning sickness when I feel nauseated all day long?
"Morning sickness" is really a misnomer. (In fact, the technical medical term is "nausea and vomiting of pregnancy.") For some pregnant women, the symptoms are worst in the morning and ease up over the course of the day, but they can strike at any time and last all day long.

About three quarters of pregnant women experience nausea and sometimes vomiting during their first trimester. The nausea usually starts around six weeks of pregnancy, but it can begin as early as four weeks. It tends to get worse over the next month or so.

About half of the women who get it feel complete relief by about 14 weeks. For most of the rest, it takes another month or so for the queasiness to ease up, though it may return later and come and go throughout pregnancy.

What causes nausea and vomiting during pregnancy?
No one knows for sure what causes nausea during pregnancy, but it's probably some combination of the many physical changes taking place in your body. Some possible causes include:

• Rapidly rising levels of the hormone human chorionic gonadotropin (hCG) during early pregnancy. No one knows how hCG contributes to nausea, but the timing is right: Nausea tends to peak around the same time as levels of hCG.

Estrogen, another hormone that rises rapidly in early pregnancy, is also considered a prime suspect, and it's possible that other hormones play a role as well.
• An enhanced sense of smell and sensitivity to odors. It's not uncommon for a newly pregnant woman to feel overwhelmed by the smell of a bologna sandwich from four cubicles away, for example, and that certain aromas instantly trigger her gag reflex. This may be a result of higher levels of estrogen.
• A tricky stomach. Some women's gastrointestinal tracts are simply more sensitive to the changes of early pregnancy.

You may have heard that morning sickness can be caused by a vitamin B deficiency. While taking a vitamin B6 supplement does seem to help ease nausea in many pregnant women, this doesn't mean they have a vitamin deficiency. In fact, at least one study has shown no significant differences in the levels of B6 in women with morning sickness and those without.

No one knows why B6 is helpful. There's also some evidence that taking a multivitamin at the time of conception and in early pregnancy helps prevent severe morning sickness, but again, no one knows why.

Some researchers have proposed that certain women are psychologically predisposed to having nausea and vomiting during pregnancy as an abnormal response to stress. However, there's no good evidence to support this theory. (Of course, if you're constantly nauseated or vomiting a lot, you certainly may begin to feel more stressed!)

Are some pregnant women more likely than others to feel nauseated?
You're more likely to have nausea or vomiting during your pregnancy if any of the following apply:

• You're pregnant with twins or higher multiples. This may be from the higher levels of hCG, estrogen, or other hormones in your system. You're also more likely to have a more severe case than average. On the other hand, it's not a definite thing — some women carrying twins have little or no nausea.
• You had nausea and vomiting in a previous pregnancy.
• You have a history of nausea or vomiting as a side effect of taking birth control pills. This is probably related to your body's response to estrogen.
• You have a history of motion sickness.
• You have a genetic predisposition to nausea during pregnancy. If your mother or sisters had severe morning sickness, there's a higher chance you will, too.
• You have a history of migraine headaches.
• You're carrying a girl. One study found that women with severe nausea and vomiting were 50 percent more likely to be carrying a girl.

Pregnancy Symptoms You Should NEVER Ignore!

(Info. provided by babycenter.com)
How do you know whether that sudden ache is normal or warrants a 2 a.m. call to your doctor or midwife? Here's a rundown of symptoms that should set off your warning bells. But even if you don't see your symptom on this list, it's better to err on the side of caution and make that call than to agonize for hours, wondering whether you've pulled a ligament or gone into preterm labor.

*Note that some of these symptoms may be more or less urgent depending on your particular situation or health history and on how far along you are in your pregnancy. Ask your practitioner to review with you which signs warrant an urgent call at various points in your pregnancy.

• Your baby is moving or kicking less than usual (once he begins moving regularly). Ask your caregiver if you should monitor your baby's activity by doing daily "kick counts." She can give you specific instructions on how to count and when to call.
• Severe or persistent abdominal pain or tenderness.
• Vaginal bleeding or spotting.
• An increase in vaginal discharge or a change in the type of discharge — that is, if it becomes watery, mucousy, or bloody (even if it's only pink or blood-tinged). Note: After 37 weeks, an increase in mucus discharge is normal and may indicate that you'll be going into labor soon.
• Pelvic pressure (a feeling that your baby is pushing down), lower back pain (especially if it's a new problem for you), menstrual-like cramping or abdominal pain, or more than four contractions in an hour (even if they don't hurt) before 37 weeks.
• Painful or burning urination, or little or no urination.
• Severe or persistent vomiting, or any vomiting accompanied by pain or fever.
• Chills or fever of 100 degrees Fahrenheit or higher.
• Visual disturbances such as double vision, blurring, dimming, flashing lights, or "floaters" (spots in your field of vision).
• Persistent or severe headache, or any headache accompanied by blurred vision, slurred speech, or numbness.
• Any swelling in your face or puffiness around your eyes, anything more than a little swelling in your hands, severe and sudden swelling of your feet or ankles, or a rapid weight gain (more than 4 pounds in a week).
• A persistent or severe leg cramp or calf pain that doesn't ease up when you flex your ankle and point your toes toward your nose or when you walk around, or one leg being significantly more swollen than the other.
• Trauma to the abdomen.
• Fainting, frequent dizziness, a rapid heartbeat, or heart palpitations.
• Difficulty breathing, coughing up blood, or chest pain.
• Severe constipation accompanied by abdominal pain or severe diarrhea that lasts more than 24 hours.
• Persistent intense itching of your torso, arms, legs, palms, or soles, or a feeling of itchiness all over your body.
• Any health problem that you'd ordinarily call your practitioner about even if it's not pregnancy related (like worsening asthma or a cold that gets worse rather than better). Just call a little sooner than you would normally.

If you're not sure whether a symptom is serious, you don't feel like yourself, or you're uneasy, trust your instincts and call your healthcare provider. Your practitioner expects such calls. If there's a problem, you'll get help right away. If nothing's wrong, you'll be reassured.

Your body is changing so rapidly that it's hard to know whether what you're experiencing is "normal." Do yourself and your baby a favor and get any unusual symptoms checked out.

Finally, if you're near your due date, check out the signs of labor so you'll know what to look for and when to call your caregiver.

Is Taking an Infant CPR Class Really Necessary?

(an experience told by Gail Klanchesser )

When I was expecting my first child I remember my childbirth class instructor suggesting everyone take a CPR course. At the time I was a practicing EMT, so I was already certified and didn't think much of it. A few months later I belonged to a post partum group and someone I new from the Fire Service came to discuss why parents should take a CPR class. Attending a CPR class is a really good idea, but how many new parents are able to fit it in with everything else that needs to be done before the baby arrives? We all know how to call 911 and in many areas the 911 dispatcher will provide EMD - Emergency Medical Dispatching. But how well would we be able to follow the dispatchers directions to provide effective CPR?

Recently a study was done in England. Volunteers from a prenatal class were provided a telephone and an infant mannequin and instructed that they had just discovered an unresponsive infant. They were told to call for help and to follow the dispatcher's instructions. Despite changes made a few years ago to make CPR easier to explain and perform, the volunteers did not perform CPR effectively. The study concluded that emergency CPR instruction over the phone needed improvement and that new parents in a real emergency would probably perform infant CPR less effectively than the study participants. (AHA Currents Winter 2008-09 citing Resuscitation, 2008; 76:63-68)

In a true emergency we panic, even professionals will panic if it is a member of their own family. A CPR class can give a new parent confidence so that if an emergency happens, and if they do panic, they will know to call 911 and that the 911 dispatcher's instructions will help them to remember what they practiced in their class.

A CPR class is a good, hands-on way to learn CPR. But for many expecting or new parents, finding the time (and possibly a sitter) to attend a class is difficult at best. One method to assist new parents is the American Heart Association's CPR Anytime program. Parents can purchase a DVD and inflatable mannequin and in 25 minutes of following the directions on the DVD they can learn the steps of infant CPR. For more information on the CPR Anytime program visit their website, www.cpranytime.org.

Gail Klanchesser is the owner of Coastal CPR & First Aid in New Hampshire. She is a mom of 4, an American Heart Association Instructor and a part-time Emergency Dispatcher. She offers private in-home and corporate CPR and First Aid classes. You can learn more about Coastal CPR & First Aid at www.coastalcpr.com.

Infant CPR

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