Rubella is a mild viral infection that can cause a rash or fever in an infected individual. This viral infection is most commonly known as German measles, even though there is no actual connection to measles. This virus can affect infants and adults and rarely causes any complications. However, there are some serious complications associated with Rubella and as a midwife would be good to know….they primarily affect infants after maternal infection in the first trimester.
Some common symptoms of rubella are usually seen two to three weeks after infection. Most symptoms are mild and may include:
-A pink rash that spreads downward from the face. This usually affects 50 percent of cases and is typically the first sign of infection. The rash will resemble the measles rash on the first day. However, there will be no additional measles symptoms. On the second day the rash will turn bright pink and merge into larger areas. On the third day the rash will usually disappear.
-The patient’s lymph nodes will be enlarged.
-Children may have a mild fever. Adults may have a high fever and headaches.
Some less common symptoms include:
-Joints that ache
-Enlarged spleen
-Conjunctivitis
-A red throat and cough
This viral infection is contagious for 10 days before the rash appears and for 10 days after the rash disappears.
There is no specific treatment for rubella. A rubella vaccine is often administered to infants as a preventive measure. It is administered as part of the MMR vaccine which is usually given to babies between 12-15 months. Women of child bearing age, who test negative to rubella antibodies, are urged to get vaccinated. Women who are pregnant, who have suppressed immune systems or who are allergic to the antibiotics neomycin and polymyxin should not be administered the rubella vaccine.
Because there is no specific treatment for rubella, most symptoms must be treated individually. The fever associated with the virus can be relieved by drinking lots of fluids and taking a fever reducing medication.
The varicella-zoster virus can cause two types of diseases that can affect both the young – chicken pox and shingles. Both diseases can be spread by droplet infection are considered infectious until all of the scabs fall off. Chickenpox is usually considered an adolescent disease but it is also very common in adults. Shingles is more common in adult life and is caused by the reactivation of the chickenpox virus, when the immune system is compromised.
The severity of the chickenpox virus depends mostly on the age of the infected person. Children with chickenpox will often have a rash on the body. Typically the child will not feel well. Adults that are infected will usually have more severe symptoms between the time that they are infected and when the infection actually appears. Symptoms during this period may include fever, malaise, headache, and a blotchy rash, which is not the same as the true rash which will develop.
The true rash will look the same in children and adults. It will appear pink/red with small raised spots that have small blisters. The spots are elliptical in shape and will erupt on the skin in irregular intervals over several days. There is a cycle of development. Firs the pink spot will appear on the skin. Next the small blister will protrude from the spot and finally a scab will form over the blister. The scab will eventually fall off and the skin beneath will be clear.
The chickenpox rash is usually distributed towards the center of the body. The trunk, face, scalp and upper limbs will be laden with the chickenpox rash. Severe attacks can cause the blisters to cover the entire body. The mouth, throat, nose and conjuctivae of the eyes can also develop blisters. The chickenpox virus is considered infectious until all of the scabs dry and fall off.
There is no specific treatment for chickenpox. There are several effective home remedies that have been passed down that work well. Topical anti-itch lotions can be applied. Talcum powder can also be used to relieve itching. Soaking in an oatmeal bath has also been found to help relieve itching. Some people cover the blisters with clear nail polish to speed up the drying process.
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Lactation Consultant: Natural Ways To Improve Milk Supply
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Not every woman produces the same amount of milk for breastfeeding. Some women are have excellent milk production and require no assistance. Other woman may find making enough milk to satisfy their infants needs to be difficult. If you are having a hard time producing enough milk for your baby there are are several foods and herbs that are suggested by lactation consultants and you can take them to naturally help build milk supply.
Cereals: Eating cereals made from oats, barely and corn have been found to help make milk. Ideally, you should consume these cereals raw. Rolled oats can be made into milk. Barley is best soaked in water for two days until soft. Milk and honey can be added for flavor. Raw corn from the cob is aslo ideal for building your milk supply.
Onion Family: All members of the onion family are wonderful for making milk. Garlic, onions, chives, leeks and shallots can build your supply but may cause colic in your baby. Only eat members of the onion family in moderation and observe your baby’s response after breastfeeding. If your baby is fussy after meals, eat these types of foods sparingly.
Legumes: All legumes eaten fresh and raw or cooked are great for building your milk supply. Lentils and chickpeas have been found to be especially beneficial to milk production.
Raw fruits: Apples, pears, bananas, grapes and peaches are beneficial. Berries are also good. Citrus fruits are not beneficial at all and can decrease your milk production if they are eaten in excess.
Root vegetables: Root vegetables, especially carrots, sweet potatoes and parsnips are good for your milk supply.
Green herbs: Comfrey leaves, dill, coriander, watercress, and borage are excellent for milk production.
Seeds: Sunflower, celery, onion carrot and poppy seeds are beneficial.
Your baby’s first bowel movements should occur while you are in the hospital during the firs or second day after baby’s birth. This first bowl movement is usually a thick, dark-green, or black substance called merconium. Merconium usually fills the intestines before birth and must be eliminated before normal digestion can occur. Your baby will have normal, yellow-green, stools as soon as all of the merconium is expelled from the intestines. We asked a midwife FAQ to give us the down low on your baby and the first stages of bowel movements.
If your baby is breastfed, he will usually have light mustard colored stools with seed-like particles. This is very normal and will continue until he starts to eat solid foods. Breastfed babies usually have soft runny stools. If your baby is formula-fed, his stools will probably be yellow or tan in color and will be not as soft as a breastfed baby’s stool.
Hard stools are a sign of constipation and usually indicate that your baby is not getting enough fluid, or that he is loosing too much fluid because of illness, heat or fever. Hard stools can also occur when your baby starts eating solid foods. If this happens, your baby may be eating to many constipating foods before he is able to digest them completely. Cereal and cow’s milk are foods that commonly cause constipation in infants. Whole cow’s milk is not recommended for babies younger than twelve months.
Your baby’s stools can vary depending in color and consistency depending on the types of food that were consumed that day. If your baby ate a lot of cereal, his digestion may become slower and may become green. If you give your baby iron supplements, his stools will look dark brown. Light tinges of blood may appear on the outside of your baby’s stools if his anus become irritated. This can occur when your baby is constipated. If larger amounts of blood, mucus or water are present in your baby’s stools, you should contact your pediatrician or midwife immediately. Your baby may have an intestinal abnormality that should be addressed right away.
You probably have sweet smelling infant shampoos and body washes that you are anxious to use on your new born infant. You will have many opportunities to use these cleansers as your baby grows but during the first year, you will only need to give your baby two to three baths per week. During the first one to two weeks, while your baby’s umbilical cord is still attached you will only be able to give your baby sponge baths.
Your baby’s sponge bath should be done in a warm room. It is best to lay your baby on a flat comfortable surface, such as a changing table, bed, or counter next to the sink. Hard surfaces can be padded with a towel. If you bathe your baby on a surface above the floor be sure to keep at least one hand on your baby at all times to ensure that she does not fall.
You will need a basin of water, wash cloth, and mild baby soap. It is best to keep your baby wrapped in a towel. Only expose the parts you are actively washing. The face should be washed with a damp cloth that does not have any soap on it so that you do not get soap in your baby’s eyes or mouth. After your baby’s face is washed, the cloth should be dipped in a basin of soapy water and the rest of your baby’s body can be washed. The creases under the arms, behind the neck, ears and genital areas should be washed well. The diaper area should be the last area that is cleaned.
When the umbilical area is finally healed, you can give your baby a regular bath. Babies are amazingly slippery and it is often helpful to use a small baby bath tub, sink or tub lined with a clean towel to keep your baby from slipping and sliding around in the tub. You only need to fill the basin with two inches of warm water. Be sure that the water is not too hot by testing the temperature on the inside of your wrist or elbows.
A baby’s umbilical cord will usually fall off within one to two weeks after birth if the area is kept dry. Here are several umbilical concerns that could cause you to call your pediatrician.
Umbilical Cord: The stump of your baby’s umbilical cord should be kept clean and dry. After a few weeks the umbilical should fall off. Health-care providers suggest that a cotton swab soaked in alcohol should be used to clean away any wet, sticky material that may be at the base of the umbilical stump next to the skin, at each diaper change. This will help to dry out the cord. The diaper should also be folded below the umbilical cord to keep urine from making it wet. If you notice a few drops of blood on the diaper, do not worry. This is normal when the stump falls off. You should contact your pediatrician if you notice any pus at the base of the cord, red skin around the base of the cord or if your baby cries when you touch the cord or the skin around the cord.
Umbilical Granuloma: An umbilical granuloma occurs when the umbilical cord falls off the area continue to be moist and possibly swollen. A drying medication called silver nitrate can be used to dry out the area. If the granuloma does not disappear, it may need to be surgically removed. This is a simple procedure that does not require the use of anestheic or hospitalization.
Umbilical Hernia: An umbilical hernia occurs when your baby’s umbilical cord pushes outward when he cries. This is caused by a small hole in the muscular part of the abdominal wall. The tissue in the area bulges when pressure is placed on the abdomen. This condition will usually heal itself within the first twelve to eighteen months. If the whole does not repair itself it may need to be surgically closed.
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Ask A Midwife: How to Avoid Postpartum Complications
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Many postpartum complications can be avoided or reduced. There are three simple things you can do to decrease your chances of experiencing any postpartum complications.
Avoid Interventions
Every procedure or intervention increases your risk of experiencing postpartum complications. Before you are in the delivery room, determine which procedures you are willing to do with your midwife or dula and which procedures you do not want to do. Study up on the complications associated with the common procedures and interventions performed in most delivery rooms. Increasing your knowledge about the procedures that are regularly done by your doctor can give you an idea of what to possibly expect during your labor. By learning and preparing yourself to make important decisions concerning your health and the health of your baby, you may be able to ensure a positive birth experience. Research has found that negative birth experiences are linked to postpartum depression and posttraumatic stress disorder. A great way to lessen any negative effects is to choose a health-care provider that you trust.
Learn About The Process
There are so many great resources about what to expect during labor, delivery and postpartum. Take some time and learn all you can. Read childbirth books, take labor classes like Lamaze, and study about some of the different labor options available. There are many different ways to have a baby. Some mothers choose to have home births. Other mothers have water births. Regardless of which delivery you choose, study up on what to expect concerning that specific process. The more you know the less fearful you will be.
Communicate
Once you have determined your birth plan and figured out which procedures you do and do not want to experience, sit down with your health-care provider and discuss your ideas. Ask your doctor or midwife about his or her philosophy on birth and intervention, as well as how he or she will help you to avoid unnecessary or unwanted medical procedures. You should ask these questions before the third trimester so that you have time to change health-care provider’s, if you do not agree with your current health-care provider’s philosophies.
Visit Your Birthplace
Many hospitals and birth centers offer tours to expectant mothers. You should take some time to check out the facility that you will be delivering your baby in. A tour is a great way to see the facility and ask questions about their policies and procedures. Can you eat or drink during labor? Are Ivs required? Do they have lactation consultants to assist with breastfeeding?
Your birth experience will be unique and memorable. Besides mentally preparing yourself for the physical challenges of delivery you may want to understand how certain birthing experiences could affect you postpartum. Every procedure or intervention could affect you after your baby is born. Medications, Ivs, fetal monitoring devices and even the position you are in when you push your baby out can affect your ability to recovery quickly.
When creating your birthing plan you should consider how any possible interventions and medications could affect your baby and you after delivery. The following interventions or procedures are known to affect postpartum recovery. You may want to discuss these potential birth experiences with your obstetrician.
Narcotic Pain Relief
Many women worry about the pain of labor. Some women are adamant about not using any type of pain medication during labor. Other women have already told their doctor to use the biggest and most powerful pain medication available as soon as possible. What you should be aware of is that narcotic drugs like Demerol, Stadol and Nubian can make you feel spacey when your child is born. These drugs also stay in your system for several weeks and can make breastfeeding difficult.
Epidurals
There are many side effects associated with epidurals. Some women experience severe headaches, fever, pain and itching at the injection site, uneven numbing, and a serious and sudden drop in blood pressure. Women who choose to have an epidural are more likely to have a forceps delivery, episiotomy or c-section.
Antibiotics
Antibiotics are typically used during labor and birth. Unfortunately they can cause postpartum problems such as vaginal yeast infections, allergic reactions, and thrush. To reduce the impact of antibiotics on your system, eat lots of probiotic foods like yogurt, kefir, kimchi, or miso.
Fetal Monitoring
If your baby requires constant fetal monitoring you may find yourself stuck in bed. This could slow down the delivery process and increase your chances of needing an epidural or other pain medication.
An internal fetal monitoring device may also be used. This type of device requires an electrode to be placed on your baby’s scalp while inside your uterus. This type of monitoring device increases your chances of developing a yeast infection and also increases your baby’s risk for scalp infection. This type of monitoring is most effective compared to the external monitoring device.
If you are pregnant, you have probably wondered what labor will be like. Perhaps you have heard stories from your mom about your birth. You may have family members or friends who have shared their personal birthing stories with you. There are a lot of opinions about labor and delivery. Before you jump to any conclusions, here is some information from a Midwife about some common procedures that you may experience during labor.
Episiotomy
An episiotomy is an incision that is made through layers of tissue and muscle in the perineum. Many care providers routinely do episiotomies. Most episiotomies are considered unnecessary and may even be cause for postpartum problems. An episiotomy is very painful and can delay your healing time compared to natural tears. Research has found that natural tears heal much faster than episiotomies. There is also and increased risk of infection following an episiotomy. You should consult with your health-care provider about his or her episiotomy rates and discuss your desire not to have an episiotomy as part of your birth plan. There are several techniques that could help you to avoid having an episiotomy. They are: giving birth in an upright position; pushing when you have an urge to push and not on demand; and perineal massage while pushing.
C-sections
C-sections have become increasingly popular over the years. More and more women are choosing to deliver by c-section in order to set the exact date of birth. Many experts believe that emergency c-sections play an important role in saving lives but that too many unnecessary c-sections are being performed in the United States. Women should be aware that there is a much longer and more painful recovery time following a c-section. Women who deliver by c-section also increase their risk of infection and other short and long-term side effects.
Returning to work after delivering a baby is one of the most stressful experiences for a mother. It can be very challenging to juggle the demands of employment with the needs of a newborn and your own physical exhaustion. Many employers are beginning to offer flexible work programs that can benefit new mothers and the employers. Studies have shown that public health benefits from embracing and nurturing the mother/child dynamic regardless of bottom line. Supporting our mothers in the community pays off. Here are some options for mothers who may be returning to work soon.
Earned time is a flexible work program that uses sick leave, vacation and personal days. These days are generally grouped into one set of paid days off that a mother can use at her own discretion. This benefits the mother because she does not have to justify time off with her supervisor. This time is often earned over several years. New mothers who have accrued earned leave may be able to have a substantial amount of paid leave after childbirth. Employers find a value in offering this benefit because it promotes loyalty from their workers. Also, workers who are provided with this benefit are usually willing to work harder for their company because their personal needs are being met.
Part-time employment is a work program that allows an employee to work less than 35-40 hours a week. This type of work schedule allows mothers more time to be at home. Many part-time schedules are more flexible than full-time schedules. Providing this work option is beneficial to employers because it helps them to retain valuable employees and saves them from having to recruit and train new workers.
Job sharing is another type of work program that occurs when two workers share the responsibility and duties of one job, but both work on a part-time basis. This is beneficial for mothers who want more time at home but want to keep the same job. Employers usually offer this program because it saves them money in benefits, rehiring and training.
Phase back occurs when an employer allows workers to gradually return to a full-time work schedule over several weeks or months. This provides the mother with more time to adjust to returning to work and gives her more time with her baby. Employers generally provide this benefit because they have found that it promotes loyalty and dedication from workers.
