Important Point to Remember:

Your infant should have a wide open mouth and should be covering most if not all of areola.
Do not allow your infant to latch only on to the nipple.
It takes a little time to learn your baby’s feeding cue’s especially during the first two weeks.
Breast feed “on demand”, which means when they show signs of hunger such as : increased body movements such as stretching or sucking their hands. Other signs of hunger include the “rooting reflex” which is when your infant turns his or her head with a wide open mouth as if your baby is searching for your nipple.
Avoid waiting till your infant is “crying” for a feed.

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The Cradle Position. Once again, place one or two pillows in your lap. These will support your baby. You would then place your baby’s head in the crook of our arm. Be sure your baby is turned to you “tummy to tummy”. Your breast should be supported with your hand in the “C” position, thumb on top of your breast, fingers below. Be sure to keep fingers away from the areola. Again, tickle your baby’s lips until he opens wide then quickly guide your baby onto your breast.

Football / Clutch. Place a pillow or two at your side to support your baby and your arm. The baby should almost be laying on the pillow with your hand supporting his neck, head and lower back. Your forearm should be supporting his upper body against your side. Follow as in the “cradle and crossover” hold. This position is preferred by women who have had Cesarean Sections.

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Preventing nipple tenderness comes from correct positioning and latch on. A baby is correctly positioned when he starts with a wide open mouth. The nipple should sweep his or her lips until the baby opens his mouth wide. The areola (dark area around the nipple) should be completely covered. The infants lips should be turned out and his/her tongue should be under your nipple.

Positioning:

The Cross over hold. Be sure to be comfortable when you are ready to breast feed. It is usually easy to nurse in bed or in a chair. Make sure to support your back. Unwrap your baby, this allows you to awaken your infant making it easier for positioning. Place one or two pillows on your lap so the baby will be directly at your breast. Your baby should be on his side wit chest and abdomen against your body. Your hand should support his head and neck.

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Fact: Getting too little sleep will harm you. It can

Reduce your immunity, so you become more susceptible to various diseases.
Impair your thought processes, so you make more mistakes.

Affect your reflexes and balance, increasing your chances of falling and injuring yourself.
Make you more susceptible to high blood pressure and its complications, such as heart attack and stroke.
Myth: People who threaten suicide rarely go through with it.

Fact: Don’t you believe it! People who threaten suicide frequently mean it. Always take that threat seriously. When someone threatens suicide, your job is to get professional help for him or her immediately and help avert the tragedy.

Myth: Having an alcoholic drink at bedtime will help you sleep better.

Fact: Alcohol may help you fall asleep more easily, but it interferes with sleep later on. As a result, you don’t sleep as soundly and you wake up frequently. And in the morning, you wake up tired. The more alcohol you drink the worse the problem becomes.

Myth: You should expect to gain weight as you get older.

Fact: Many people do gain weight as they get older, but that doesn’t make it inevitable. As you get older, you tend to become less physically active and therefore, burn fewer calories.

However, you often keep eating the same number of calories. This can result in gradual weight gain, which is an invitation to all the illnesses and complications of being overweight.

The solution is pretty straightforward: as you get older, maintain a regular exercise program. If that’s impossible, the next best solution is to eat fewer calories. Ideally, at 70 you should weigh what you weighed at 20.

Fact: If you switch to low-yield cigarettes, your chances of developing lung cancer, emphysema and heart disease are essentially the same as with conventional cigarettes.

Myth: Using a sugar substitute will help you lose weight.

Fact: Studies show that people who use a sugar substitute do not lose any more weight than people who don’t use a sugar substitute.

Myth: If you exercise to lose weight, you will have a bigger appetite, eat more and fail to lose weight.

Fact: By and large, people who exercise regularly have normal appetites and do not eat more food. Exercise does burn up more calories and does help you lose weight.

Myth: If you have cirrhosis of the liver, it means you suffer from alcoholism.

Fact: Cirrhosis of the liver has a number of different causes. Alcohol is one of them.

However, a tooth abscess is nothing to be trifled with, regardless of your ability to withstand pain.

If you have any of the following signs of an abscess, you may have a serious infection that requires emergency treatment.

severe or sharp pain in a tooth or the jaw

a loose tooth

red, swollen or bleeding gums

fever

Fever. Earache. Swollen glands in the neck. Sudden severe pain in tooth or jaw when descending in an airplane.

If these symptoms occur, call your dentist for an immediate appointment.

*So That’s What They’re For* is also hot off the press, covering some interesting new research that I had never heard of. Did you know that breast milk not only provides passive immunity to your baby, but that also your baby transfers, when nursing, any germs that he’s picked up through your areola to your mammary glands, which miraculously produce specific antibodies that your baby drinks in with your milk, helping to fight off a cold? Hard to believe, but according to three different studies, it’s true. Also, did you know that formula was originally developed as a way to make use of a dairy byproduct called whey, the dubious leftover stuff after milk, butter, and cheese are produced? Or that breastfeeding during the first year of life increases I.Q. by an average of 8.3 points? The book is peppered with fascinating facts like these, backed by solid research. And I thought I knew it all!

I highly recommend this book, not just as a nursing guidebook for beginners but as a fun, educational, rousing read for old campaigners, skeptics, or anyone who cares about the health and well-being of children. Take it with you to the beach, give it as a gift to new Moms, recommend it to your pediatrician, midwife, ob-gyn or husband. Tamaro should be applauded for treating a battle-scarred topic in a fresh, inclusive, and humorous way.

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It was a welcome relief, therefore, to read Janet Tamaro’s humorous guide to breastfeeding, which is not only informative but politically engaged and, best of all, funny. I found myself giggling out loud several times — at Janet’s bare-breasted encounter with the UPS man at her door, at her husband’s secret taste test of Janet’s pumped milk with a friend in the living room (“You try it,” “No, you try it first!”), at the Mom who went through the fast-food drive-up window, you guessed it, with her nursing bra flap unhooked and her shirt wide open. The book is sprinkled with literally hundreds of anecdotes from the many, many women that Janet interviewed in writing the book — so that even though I am an experienced nurser who didn’t really need a review of “the basics,” I still enjoyed the read and the positive affirmation of my own experience echoing through the voices of many different mothers. “Yes, yes!” I found myself saying out loud as I read the book before going to sleep each night. “That’s how I feel; that’s what happened to me!”

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The study, published in the Oct. 2001 issue of Medicine & Science in Sports & Exercise, placed participants in one of three groups: the EX (exercise) group, which took part in a supervised exercise program three or four times per week; the WM (weight management) group, which exercised the same way but also participated in a behavioral weight-management program; and the CON (control) group, which maintained the same diet and activity habits.

Study participants were at least 29 years old, sedentary, overweight and had high blood pressure. Each participant was fitted with a device that could measure blood pressure on a typical workday. Participants also kept diaries that indicated time, posture, location, mood, activity and consumption of alcohol/caffeine at the time of the measurement.

Data were analyzed for 92 participants, who had an average age of 48. Both the EX and WM groups improved in aerobic fitness, and significant differences were found in blood pressure among the three groups six months after the start of the study (the groups had no differences in blood pressure at the start of the study).

The combination of exercise and weight loss caused significantly lower blood pressure and heart rate levels during both high and low levels of physical activity, and high and low levels of emotional distress. This led researchers to conclude that while exercise is effective at reducing elevated blood pressure in everyday life, exercise combined with weight loss is even better.

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I haven’t changed my diet or exercise patterns, and yet, I’m gaining weight. What can I do?
As a woman ages, there are changes that occur in her body that predispose her to weight gain, even if she does not change her eating or exercise habits. With increasing age, there is increased total body fat, decreased lean body mass and decreased basal metabolic rate. There is also a change from the female body shape to the male body shape with its associated increase in waist to hip ratio. These subsequent increases in body fat and shape can be associated with increased risk for heart disease and diabetes.

Thus as a woman ages, it is important to monitor caloric intake, decrease fat consumption and increase exercise, both aerobic and anaerobic.

What are some other dietary changes to consider?
As we age, we feel less thirsty. It’s unclear why this happens, but it does. As a result, sometimes dehydration may occur, especially during the summer months. Decreased water intake may also be associated with constipation. In light of this, it is essential to drink at least eight glasses of water a day, even if you do not feel particularly thirsty. Increasing consumption of fiber through fruits and vegetables may also relieve constipation.

Should I be taking iron supplements with my vitamins?
With decreased or lack of menstruation, iron supplements are not as necessary as they were when regular menstruation was occurring. Therefore, many over-the-counter formulations geared for the menopausal woman do not contain as much iron as would a vitamin supplement geared for a younger or regularly menstruating patient.

However, perimenopause is often accompanied by episodes of irregular but very heavy bleeding. In those cases, vitamins with iron may be beneficial. However, this is something that should be customized for each woman and, therefore, should be discussed with her healthcare provider.

Are there any lifestyle changes which might relieve my symptoms?
Absolutely.

Stop smoking! Not only does smoking increase your risk for lung cancer and heart disease, but it also is toxic to the ovaries. Smokers may have menopause onset two years earlier than non-smokers. Smoking is also toxic to bone-building cells, the osteoblasts, so smokers also are at increased risk for osteoporosis.

Layer clothing so that you can maximize comfort when experiencing a hot flush.
Try to minimize stress since stress may bring on hot flushes. Meditation, yoga or other relaxation techniques may help. At the Harvard Mind-Body program, we learned a very simple relaxation technique which can be performed any time and any place and need not necessarily interfere with whatever else is happening:

Take a deep, cleansing breath in and out and then, breathing normally, count to yourself slowly from 1 to 10 and then back from 10 to 1.
This “time out” may help to minimize stress and relieve hot flushes.

Regular exercise may help to reduce stress and will help to increase basal metabolic rate, therefore helping with weight management. Both aerobic and anaerobic exercises are important.

Bottom line: Modify diet, decrease fat and caloric intake, exercise or increase exercise, and try some relaxation techniques.
Next week, we will continue to explore treatment options for perimenopause, including hormone replacement therapy.