SINGAPORE MALAYSIA ONLINE STORE FASHION BEAUTY COSMETIC

[ Copy this | Start New | Full Size ]

Share on Facebook  

The first three months of pregnancy is the most crucial stage in your baby's development as all organs are forming. Throughout your pregnancy, but especially during the first three months, be particularly careful about using any alcohol, drugs or medication. The following information outlines substances that require special precautions during pregnancy. Instructions are also given on how to keep track of fetal movements, an important sign of how healthy a baby is. 
Alcohol
Caffeine
Cigarettes
Food Additives
Food Handling Concerns
Medications and Herbs
Saunas and Hot Tubs
Toxoplasmosis
Video Display Terminals (VDTs)
Other Precautions
Informational Hotlines - Chemical Use and Precautions


 
Alcohol

 
No one knows how much alcohol is safe to drink during pregnancy

The danger of alcohol use during pregnancy is that it may cause fetal alcohol syndrome (FAS). Babies born with FAS may:
grow more slowly
have learning problems
have distorted facial features
There is no cure for these problems caused by fetal alcohol syndrome.

Alcohol is an ingredient in many medicines you buy. For example, some cough medicines are 25 percent alcohol. Ask your health care provider if you should use the product during pregnancy. Always read the label before taking any medicine.

Precautions
The National Institute of Alcohol Abuse and Alcoholism and the March of Dimes caution pregnant women that because there is no known safe level of alcohol taken during pregnancy, the safest course to follow includes:
Completely avoid alcoholic beverages while pregnant.
Discuss your concerns regarding alcohol and pregnancy with your healthcare provider.
 
 
Back to top

 
Caffeine

 
Caffeine is a stimulant that affects individuals differently. Caffeine can cause nervousness, irritability, anxiety, irregular heartbeats and difficulty in sleeping. How caffeine affects the fetus is still under investigation. Some scientists believe caffeine can cause premature or smaller than normal babies, or possible birth defects.

Precautions
Cut down or eliminate food and drinks which contain caffeine such as coffee, tea, colas and other soft drinks, cocoa and chocolate.
Caffeine is also an ingredient in many non-prescription medicines such as headache, cold, allergy, and pills that are made to combat drowsiness.
If you have been consuming caffeine in large quantities, gradually decrease your intake. Severe headaches, nausea, fatigue and other symptoms may accompany an abrupt withdrawal. Check with your health care provider for more information.
 
 
Back to top

 
Cigarettes

 
Cigarette smoking may lead to serious health problems. Women who smoke during pregnancy usually have smaller babies than non-smoking women. Low birth
weight babies are more likely to have health problems such as:
Infections
Trouble keeping warm
Feeding problems
Breathing difficulties.
Sudden Infant Death Syndrome
In addition, new research has found significant health problems related to exposure to second hand smoke and a link to Sudden Infant Death Syndrome (S.I.D.S.).

Precautions
Stop smoking or cut down your smoking when pregnant. There are many community programs available to assist you. Call the American Cancer Society for information on Smoke-Stopper Programs in your area. Call 1-800-NOBUTTS(800-662-8887).
Avoid smokers and smoking areas whenever possible.
 
 
Back to top

 
Food Additives

 
Precautions
Whenever possible, try to minimize your use of
Processed food items (such as hot dogs)
Foods containing sodium nitrate, such as cured meats (hams, bacon, etc.); these substances may be carcinogenic (cancer-causing).
Be sure to wash fruit and and peel carrots to avoid ingesting pesticides.
 
 
Back to top

 
Food Handling Concerns

 
Since cooking food destroys bacteria or parasites, consuming raw fish, meats or poultry may increase your risk of infection or parasitic disease. Milk that is not pasteurized milk may also cause illness.

Precautions
Avoid eating raw fish (sushi, ceviche), meats or eggs.
Avoid drinking unpasteurized milk.
Cook your fish, meat, poultry and eggs thoroughly.
Always wash cutting boards after slicing any raw fish, meats, or poultry.
Recommendations
Run plastic cutting boards through the dishwasher and microwave wooden boards for five minutes.
 
 
Back to top

 
Medications and Herbs

 
Before you decide to take any medication or medicinal herbs during your pregnancy, be sure to get answers to these questions:
What is this medicine/herb?
What does it treat?
What are the side effects my baby or I may experience?
What is the smallest effective dose?
How long will I need to take this medication?
Precautions
Be cautious before using medicines that contain multiple ingredients, as these are more likely to contain extra substances, which may be harmful.
 
 
Back to top

 
Saunas and Hot Tubs

 
The use of saunas and hot tubs that maintain a temperature greater than body temperature should be avoided due to their potential for causing overheating and possible effects on the developing baby.

Precautions
Avoid possible overheating. Check with your health care provider for recommendations. 
 
Back to top

 
Toxoplasmosis

 
Toxoplasmosis is a condition caused by a parasite which can be found in cat feces, the soil of plants, and raw or undercooked meat. The parasite can cause brain damage in a developing infant if the mother becomes infected during pregnancy.

Precautions
Avoid contact with cat feces. Have someone else change the litter box.
Wash dirt from fresh produce before eating.
Use gloves when you garden.
A blood test is available to determine if you have been exposed to toxoplasmosis. Ask your health care provider for more information.
Cook all meat to at least medium, preferably well done.
 
 
Back to top

 
Video Display Terminals (VDTs)

 
At this time, there are no conclusive research findings regarding the effects of Video Display Terminals (VDT) on a developing fetus.

Precautions
Reduce your exposure to VDT's whenever possible.
Be sure to take frequent stretch breaks and look away from the screen whenever possible.
 
 
Back to top

 
Other Precautions

 
Many pregnant women are concerned about possible effects on their developing baby from using products such as household cleaners, insecticides, hair dyes, permanents, finger nail polish, electrolysis, paint fumes, high altitudes, microwaves, and tanning beds.
 

What's good for baby is also good for mother. When mothers follow nature's lead and breastfeed their babies, their own bodies benefit--so do their budgets!

Reduces the risk of breast cancer. Women who breastfeed reduce their risk of developing breast cancer by as much as 25 percent. The reduction in cancer risk comes in proportion to the cumulative lifetime duration of breastfeeding. That is, the more months or years a mother breastfeeds, the lower her risk of breast cancer.

Reduces the risk of uterine and ovarian cancer. One of the reasons for the cancer-fighting effects of breastfeeding is that estrogen levels are lower during lactation. It is thought that the less estrogen available to stimulate the lining of the uterus and perhaps breast tissue also, the less the risk of these tissues becoming cancerous.

Lessens osteoporosis. Non-breastfeeding women have a four times greater chance of developing osteoporosis than breastfeeding women and are more likely to suffer from hip fractures in the post-menopausal years.

Benefits child spacing. Since breastfeeding delays ovulation, the longer a mother breastfeeds the more she is able to practice natural childspacing, if she desires. How long a woman remains infertile depends on her baby's nursing pattern and her own individual baby.

Promotes emotional health. Not only is breastfeeding good for mother's body, it's good for her mind. Studies show that breastfeeding mothers show less postpartum anxiety and depression than do formula-feeding mothers.

Promotes postpartum weight loss. Breastfeeding mothers showed significantly larger reductions in hip circumference and more fat loss by one month postpartum when compared with formula-feeding moms. Breastfeeding mothers tend to have an earlier return to their pre-pregnant weight.

Costs less to breastfeed. It costs around $1,200 a year to formula-feed your baby. Even taking into consideration the slight increase in food costs to a breastfeeding mother, the American Academy of Pediatrics estimates that a breastfeeding mother will save around $400 during the first year of breastfeeding.

Contents

1 Lactation
2 Breast milk
3 Benefits for the infant
3.1 Reduced risk of Breast Cancer
3.2 Less Atopy
3.3 Less Celiac disease
3.4 Less Diabetes mellitus
3.5 Less Diarrhea
3.6 Greater immune health
3.7 Higher Intelligence
3.8 Less necrotizing enterocolitis
3.9 Superior nutrition
3.10 Less obesity
3.11 Fewer middle ear infections
3.12 Fewer respiratory infections
3.13 Possible protection from sudden infant death syndrome
3.14 Fewer urinary tract infections
4 Benefits for mothers
4.1 Breast cancer
4.2 Arthritis
4.3 Bonding
4.4 Hormone release
4.5 Weight loss
5 Organisational endorsements
5.1 World Health Organization
5.2 American Academy of Pediatrics
6 Breastfeeding difficulties
7 Infant weight gain
8 Methods and considerations
8.1 Early breastfeeding
8.2 Time and place for breastfeeding
8.3 Latching on, feeding and positioning
8.4 Exclusive breastfeeding
8.5 Expressing breast milk
8.6 Mixed feeding
8.7 Tandem breastfeeding
8.8 Extended breastfeeding
8.9 Shared breastfeeding
8.10 Weaning
9 History of breastfeeding
10 Sociological factors with breastfeeding
11 Economic factors of breastfeeding





Lactation

The production, secretion and ejection of milk is called lactation. It is one of the defining features of being a mammal.



Breast milk



Not all the properties of breast milk are understood, but its nutrient content is relatively stable. Breast milk is made from the nutrients in the mother's bloodstream and bodily stores. Some studies estimate that a woman who breastfeeds her infant exclusively uses 400 - 600 extra calories a day in producing milk.[10] The composition of breast milk depends on how long the baby nurses.

"Research shows that the milk and energy content of breastmilk actually decreases after the first year.[8] Breastmilk adapts to a toddler's developing system, providing exactly the right amount of nutrition at exactly the right time.[9] In fact, research shows that between the ages of 12 and 24 months, 448 milliliters of a mother's milk provide these percentages of the following minimum daily requirements:

Energy 29% Folate 76% Protein 43% Vitamin B12 94% Calcium 36% Vitamin C 60%10 Vitamin A 75% "[4]




Benefits for the infant

An African woman with her child in Kabala in 1960s.During breastfeeding nutrients and antibodies pass to the baby[11] and the maternal bond can also be strengthened.[12] Research has demonstrated a variety of benefits to breastfeeding an infant. [13] These include:



Reduced risk of Breast Cancer

A study at the University of Wisconsin found that women who were breast fed in infancy may have a lower risk of developing breast cancer than those who were not breast fed. [14]


Less Atopy
In children who are at risk for atopy (defined as at least one parent or sibling having atopy), atopic syndrome can be prevented or delayed through exclusive breastfeeding for four months, though these benefits may not be present after four months of age. [15] However, the key factor may be the age at which non-breastmilk is introduced rather than duration of breastfeeding.[16] Atopic dermatitis, the most common form of eczema, can be reduced through exclusive breastfeeding beyond 12 weeks in individuals with a family history of atopy, but when breastfeeding beyond 12 weeks is combined with other foods incidents of eczema rise irrespective of family history.[17]


Less Celiac disease
A review of the association between breastfeeding and celiac disease (CD) concluded that breast feeding while introducing gluten to the diet reduced the risk of CD. The study was unable to determine if breastfeeding merely delayed symptoms or offerred life-long protection.[18]


Less Diabetes mellitus
Infants exclusively breastfed have less chance of developing diabetes mellitus type 1 than peers with a shorter duration of breastfeeding and an earlier exposure to cow milk and solid foods.[19] Breastfeeding also appears to protect against diabetes mellitus type 2,[20][21] at least in part due to its effects on the child's weight.[21]


Less Diarrhea
Breastfeeding protects infants against diarrhea as compared to formula-fed peers;[22] compared to formula-fed peers, death rates due to diarrhea in breastfed infants are lower irrespective of the development level of the country.[7]


Greater immune health
Breast milk include several anti-infective factors such as bile salt stimulated lipase (protecting against amoebic infections), lactoferrin (which binds to iron and inhibits the growth of intestinal bacteria)[23][24] and immunoglobulin A protecting against microorganisms.[25]

Despite also being a factor in the transmission of HIV from mother to child, some constituents in Breast milk may be protective of infection. In particular, high levels of certain polyunsaturated fatty acids in breastmilk (including eicosadienoic, arachidonic and gamma-Linolenic acids) are associated with a reduced risk of child infection when nursed by HIV-positive mothers. Arachidonic acid and gamma-linolenic acid may also reduce viral shedding of the HIV virus in Breast milk.[26]

Breastfeeding does not appear to offer protection against allergies.[27]


Higher Intelligence
Babies with a specific variant of the FADS2 gene (approximately 90% of all babies) demonstrate an IQ an average of 7 points higher if breastfed.[28]


Less necrotizing enterocolitis
Necrotizing enterocolitis (NC), found mainly in premature births, is six to ten times more common in infants fed formula exclusively, and three times more common in infants fed a mixture of breast milk and formula, as compared to exclusive breastfeeding. In infants born at more than 30 weeks, NC was twenty times more common in infants fed exclusively on formula.[29]


Superior nutrition
Breast milk contains the ideal ratio of the amino acids cystine, methionine, and taurine to support development of the central and peripheral nervous system. Children aged seven and eight years old who were of low birthweight who were breastfed for more than eight months demonstrated significantly higher intelligence quotient scores than comparable children breastfed for less time, suggesting breastfeeding offers long-term cognitive benefits in some populations.[30]
The quality of a mother's breast milk may be compromised by stress, bad food habits, chronic illnesses,smoking, and drinking.[31] If the mother is heavily subjected to any of above factors, additional resources in particular for protein must be found. A ration must contain a heavy percentage of protein. Protein is the building block for nerves and bones. To make brain, bone and tissue, the baby must be given protein. And from two days old to at least three years. That makes strong, pretty, alert babies that sleep well and do well.[32])


Less obesity
Breastfeeding appears to reduce the risk of extreme obesity in children aged 39 to 42 months.[33] The protective effect of breastfeeding against obesity is consistent, though small, across many studies, and appears to increase with the duration of breastfeeding.[34]


Fewer middle ear infections
Increased duration of certain types of middle ear infections (otitis media with effusion, OME) in the first two years of life is associated with a shorter period of breastfeeding, in addition to feeding while lying down and maternal cigarette smoking.[35] A reduced proportion and duration of any otitis media infection was associated with breastfeeding rather than formula feeding for the first twelve months of life.[22]


Fewer respiratory infections
Breastfeeding appears to reduce symptoms of upper respiratory tract infections in premature infants up to seven months after release from hospital.[36]


Possible protection from sudden infant death syndrome
Breastfed babies have improved arousal from sleep, which may reduce the risk of sudden infant death syndrome.[37]


Fewer urinary tract infections
Breastfeeding reduced the risk of acquiring urinary tract infections in infants up to seven months post-partum. The protection was strongest immediately after birth, and was ineffective past seven months[38]


Benefits for mothers
 
Zanzibari woman breastfeedingBreastfeeding is a cost effective way of feeding an infant, and provides the best nourishment for a child at a small nutrient cost to the mother. Frequent and exclusive breastfeeding can delay the return of fertility through lactational amenorrhea, though breastfeeding is at best an imperfect means of birth control. During breastfeeding beneficial hormones are released into the mother's body.[11] and the maternal bond can be strengthened.[12] Breastfeeding is possible throughout pregnancy, but generally milk production will be reduced at some point.[39]


Breast cancer
Breastfeeding mothers have less risk of endometrial,[40][41] breast and ovarian cancer,[9][12] and osteoporosis.[9][12] Mothers who breastfeed longer than eight months also benefit from bone re-mineralisation[42] and breastfeeding diabetic mothers require less insulin.[43] Breastfeeding helps stabilize maternal endometriosis,[9] reduces the risk of post-partum bleeding[44] and benefits the insulin levels for mothers with polycystic ovary syndrome.[45]

Some breastfeeding women have pain from candidiasisor staphylococcus infections of the nipple[46] though these can be managed with medical attention with little concern for mother and child.


Arthritis
Women who breast feed for longer have a smaller chance of getting rheumatoid arthritis, suggests a Malmo University study published online ahead of print in the Annals of the Rheumatic Diseases (See Women Who Breast Feed for More than a Year Halve Their Risk of Rheumatoid Arthritis). The study also found that taking oral contraceptives, which are suspected to protect against the disease because they contain hormones that are raised in pregnancy, did not have the same effect. Simply having children but not breast feeding also did not seem to be protective.


Bonding
The hormones released during breastfeeding strengthen the maternal bond. Teaching partners how to manage common difficulties is associated with higher breastfeeding rates.[47] Support for a mother while breastfeeding can assist in familial bonds and help build a paternal bond between father and child.[48]

If the mother is away, an alternative caregiver may be able to feed the baby with expressed breast milk. The various breast pumps available for sale and rent help working mothers to feed their babies breast milk for as long as they want. To be successful, the mother must produce and store enough milk to feed the child for the time she is away, and the feeding caregiver must be comfortable in handling breast milk.


Hormone release
Breastfeeding releases the hormones oxytocin and prolactin which relax the mother and make her feel more nurturing toward her baby.[49] Breastfeeding soon after giving birth increases the mother's oxytocin levels, making her uterus contract more quickly and reducing bleeding. Oxytocin is similar to pitocin, a synthetic hormone used to make the uterus contract.[44]


Weight loss
As fat accumulated during pregnancy is used to produce milk, extended breastfeeding—at least 6 months—can help mothers lose weight.[50] However, weight loss is highly variable among lactating women, and diet and exercise is a more reliable way of losing weight.[51]


Organisational Endorsements

World Health Organization
“ [the] vast majority of mothers can and should breastfeed, just as vast majority of infants can and should be breastfed. Only under exceptional circumstances can a mother's milk be considered as unsuitable for her infant. For those few health situations where infants cannot, or should not, be breastfed, the choice of the best alternative - expressed milk from the infant's own mother, breast milk from a healthy wet-nurse or a human-milk bank, or a breast milk substitute fed with a cup, which is a safer method than a feeding bottle or a teat - depends on individual circumstances. [52] ”

The WHO recommends two years of breastfeeding and exclusive breastfeeding for the first six months of life.


American Academy of Pediatrics
“ Extensive research, especially in recent years, documents diverse and compelling advantages to infants, mothers, families, and society from breastfeeding and the use of human milk for infant feeding. These include health, nutritional, immunologic, developmental, psychological, social, economic, and environmental benefits.[9] ”

AAP recommends at least one year of breastfeeding and exclusive breastfeeding for the first six months of life.


Breastfeeding difficulties
Main article: Breastfeeding complications
Despite being a natural human activity, breastfeeding difficulties are not uncommon. Putting the baby to the breast as soon as possible after birth helps to avoid many problems. The AAP breastfeeding policy says: Delay weighing, measuring, bathing, needle-sticks, and eye prophylaxis until after the first feeding is completed.[9] Many breastfeeding difficulties can be resolved with proper hospital procedures, properly trained midwives, doctors and hospital staff, and lactation consultants.[53] There are some situations in which breastfeeding may be harmful to the infant, including infection with tuberculosis or HIV, some medications and some drugs.


Infant weight gain
Breastfed infants generally gain weight according to the following guidelines:

0–4 months: 170 grams per week†
4–6 months: 113–142 grams per week
6–12 months: 57–113 grams per week
† It is acceptable for some babies to gain 113–142 grams (4–5 ounces) per week. This average is taken from the lowest weight, not the birth weight.
The average breastfed baby doubles birth weight in 5–6 months. By one year, the typical breastfed baby will weigh about 2½ times birth weight. At one year, breastfed babies tend to be leaner than bottle fed babies.[54] By two years, differences in weight gain and growth between breastfed and formula-fed babies are no longer evident.[55];


Methods and considerations
There are many books and videos to advise mothers about breastfeeding. Lactation consultants in hospitals or private practice, and volunteer organisations of breastfeeding mothers such as La Leche League also provide advice and support.


Early breastfeeding
In the half hour after birth, the baby's suckling reflex is strongest, and the baby is more alert, so it is the ideal time to start breastfeeding. [56]. Early breast-feeding is associated with fewer nighttime feeding problems [57]

Time and place for breastfeeding
Breastfeeding at least once every two to three hours helps to maintain milk production. For most women, eight breastfeeding or pumping sessions every 24 hours keeps their milk production high.[9] Newborn babies may feed more often than this: 10 to 12 breastfeeding sessions every 24 hours is common, and some may even feed 18 times a day.[58] Feeding a baby on demand (sometimes referred to as "on cue"), may mean breastfeeding much more than the recommended minimum. Feeding when the baby shows early signs of hunger, is the best way to maintain milk production and ensure the baby's needs for milk and comfort are being met.[8] However, it may be important to recognize whether a baby is truly hungry, as breastfeeding too frequently may mean the child receives a disproportionately high amount of foremilk, and not enough hindmilk, potentially creating problems.[59].

"Experienced breastfeeding mothers learn that the sucking patterns and needs of babies vary. While some infants' sucking needs are met primarily during feedings, other babies may need additional sucking at the breast soon after a feeding even though they are not really hungry. Babies may also nurse when they are lonely, frightened or in pain.[5]"

"Comforting and meeting sucking needs at the breast is nature's original design. Pacifiers (dummies, soothers) are literally a substitute for the mother when she can't be available. Other reasons to pacify a baby primarily at the breast include superior oral-facial development, prolonged lactational amenorrhea, avoidance of nipple confusion and stimulation of an adequate milk supply to ensure higher rates of breastfeeding success.[6]"

Babies usually show they are hungry by waking up (newborns), mouthing their fists, moaning or fussing. Crying is a late indicator of hunger. When a baby's cheeks are stroked, the rooting instinct makes it move its face towards the stroking and open its mouth.

Breastfeeding can make mothers thirsty, especially at first, when both mother and baby are inexperienced and when feeding sessions can last for an hour or more (there is no time limit for breastfeeding). Having water readily available helps mothers maintain proper hydration.

 
Rooming-in bassinetMost US states now have breastfeeding laws which allow a mother to breastfeed her baby anywhere she is allowed to be. In hospitals, rooming-in care is used for breastfeeding. There are breastfeeding rooms in some places, including hypermarkets.


Latching on, feeding and positioning
When the nipple strokes the baby's cheek the baby will open its mouth and turn towards the nipple. To help the baby latch on well, tickle the baby's top lip with the nipple, wait until the baby's mouth opens wide, then bring the baby up towards the nipple quickly, so that the baby has a mouthful of nipple and areola. The nipple should be at the back of the baby's throat, with the baby's tongue lying flat in its mouth. Inverted or flat nipples can be massaged so that the baby will have more to latch onto. Resist the temptation to move towards the baby, as this can lead to poor attachment.

Many women wear nursing brassieres for easier access to the breast, but these are not always necessary and certainly not required. In the very early days, wearing a nursing bra can make breastfeeding complicated and uncomfortable. Wearing a bra at any time after birth will not affect how the breast changes with pregnancy and breastfeeding. Many women find that the size of their breasts change dramatically and so fitting a bra is better done after childbirth rather than before. An ill-fitting bra, whether designed for nursing or otherwise, can cause plugged ducts or mastitis.

Pain in the nipple or breast is linked to incorrect breastfeeding techniques. Failure to latch on is one of the main reasons for ineffective feeding and can lead to infant health concerns. A 2006 study found that inadequate parental education, incorrect breastfeeding techniques, or both were associated with higher rates of preventable hospital admissions in newborns.[60]

The baby may pull away from the nipple after a few minutes or after a much longer period of time. Normal feeds at the breast can last a few sucks (newborns), from 10 to 20 minutes or even longer (on demand). Sometimes, after the finishing of a breast, the mother may offer the other breast.

The length of feeds varies a lot. Regardless of the time taken, the breastfeeding mother should be comfortable.

Upright: The sitting position with the back straight and leaning back comfortably.
Mobile: The mother carries her nursling in a sling or other baby carrier while breastfeeding. Doing so permits the mother to incorporate breastfeeding into the varied work of daily life
Lying down: Good for night feeds or for those who have had a caesarean section
On her back: Mother is usually sitting slightly upright; particularly useful for tandem breastfeeding (nursing more than one child)
On her side: The mother and baby lie on their sides
Hands and knees: The mother is on all fours with the baby underneath her (not usually recommended)
While most women breastfeed their child in the cradling position, there are many ways to hold the feeding baby. It depends on the mother and child's comfort and the feeding preference of the baby. Some babies prefer one breast to the other, but the mother should offer both breasts at every nursing with her newborn.

Cradling positions:
Cradle hold: The baby is held with its head in the woman's elbow horizontally across the abdomen, "tummy to tummy", with the woman in an upright and supported position image
Cross-cradle hold: As above but the baby is held with its head in the woman's hand
Football hold: The woman is upright and the baby is held securely under the mother's arm with the head cradled in her hands. This position is especially useful for feeding twins simultaneously image
Feeding up hill: The baby lies stomach to stomach with the mother who is lying on her back; this is helpful for babies finding it difficult to feed
Lying down:
On its side: The mother and baby lie on their sides
On its back: The baby is lying on its back (cushioned by something soft) with the mother on her hands and knees above the child (not usually recommended)
When tandem breastfeeding, the mother is unable to move the baby from one breast to another and comfort can be more of an issue. As tandem breastfeeding brings extra strain to the arms, especially as the babies grow, many mothers of twins recommend the use of more supporting pillows. Favored positions include:

Double cradle hold
Double clutch hold image
One clutched baby and one cradled baby
Lying down

Exclusive breastfeeding
Exclusive breastfeeding is when an infant receives no other food or drink besides breast milk.[8] National and international guidelines recommend that all infants be breastfed exclusively for the first six months of life. It is generally accepted that newborns should be exclusively breastfed for around 6 months. Breastfeeding may continue with the addition of appropriate foods, for two years or more. Exclusive breastfeeding has dramatically reduced infant deaths in developing countries by reducing diarrhea and infectious diseases.

Exclusively breastfed infants feed anywhere from 6 to 14 times a day. Newborns consume from 30 to 90 ml (1 to 3 US fluid ounces). After the age of four weeks, babies consume about 120ml (4 US fluid ounces) per feed. Each baby is different, but as it grows the amount will increase. It is important to recognize the baby's hunger signs. It is assumed that the baby knows how much milk it needs and it is therefore advised that the baby should dictate the number, frequency, and length of each feed. The supply of milk from the breast is determined by the number and length of these feeds or the amount of milk expressed. The birth weight of the baby may affect its feeding habits, and mothers may be influenced by what they perceive its requirements to be. For example, a baby born small for gestational age may lead a mother to believe that her child needs to feed more than if it larger; they should, however, go by the demands of the baby rather than what they feel is necessary.

While it can be hard to measure how much food a breastfed baby consumes, babies normally feed to meet their own requirements.[61] Babies that fail to eat enough may exhibit symptoms of failure to thrive. If necessary, it is possible to estimate feeding from wet and soiled nappies (diapers): 8 wet cloth or 5–6 wet disposable, and 2–5 soiled per 24 hours suggests an acceptable amount of input for newborns older than 5–6 days old. After 2–3 months, stool frequency is a less accurate measure of adequate input as some normal infants may go up to 10 days between stools. Babies can also be weighed before and after feeds.


Expressing breast milk
 
Manual breast pumpWhen direct breastfeeding is not possible, a mother can express (artificially remove and store) her milk. With manual massage or using a breast pump, a woman can express her milk and keep it in freezer storage bags, a supplemental nursing system, or a bottle ready for use. Breast milk may be kept at room temperature for up to ten hours, refrigerated for up to eight days or frozen for up to four to six months. Research suggests that the antioxidant activity in expressed breast milk decreases over time but it still remains at higher levels than in infant formula.[62]

Expressing breast milk can maintain a mother's milk supply when she and her child are apart. If a sick baby is unable to feed, expressed milk can be fed through a nasogastric tube.

Expressed milk can also be used when a mother is having trouble breastfeeding, such as when a newborn causes grazing and bruising. If an older baby bites the nipple, the mother's reaction - a jump and a cry of pain - is usually enough to discourage the child from biting again. (Another possibility is responding to the bite by drawing the baby so close that his nose is covered and he cannot breathe without releasing.[63]) Babies or toddlers that are truly feeding cannot physically bite the nipple.

"Exclusively Expressing", "Exclusively pumping" and "EPing" are terms for a mother who feeds her baby exclusively on her breastmilk while not physically breastfeeding. This may arise because her baby is unable or unwilling to latch on to the breast. With good pumping habits, particularly in the first 12 weeks when the milk supply is being established, it is possible to produce enough milk to feed the baby for as long as the mother wishes. Kellymom [7] has a page of links relating to exclusive pumping.

It is generally advised to delay using a bottle to feed expressed breast milk until the baby is 4-6 weeks old and is good at sucking directly from the breast.[64] Because It takes less effort to suck from a bottle, a baby might lose its desire to suck from the breast. This is called nursing strike or nipple confusion. To avoid this when feeding expressed breast milk (EBM) before 4-6 weeks of age, it is recommended that breast milk be given by other means such as feeding spoons or feeding cups. Also, EBM should be given by someone other than the breastfeeding mother (or wet nurse), so that the baby can learn to associate direct feeding with the mother (or wet nurse) and associate bottle feeding with other people.[citation needed]

Some women donate their expressed breast milk (EBM) to others, either directly or through a milk bank. Though historically the use of wet nurses was common, some women dislike the idea of feeding their own child with another woman's milk; others appreciate being able to give their baby the benefits of breast milk. Feeding expressed breast milk—either from donors or the baby's own mother—is the feeding method of choice for premature babies.[65] The transmission of some viral diseases through breastfeeding can be prevented by expressing breast milk and subjecting it to Holder pasteurisation.[66]

Mixed feeding
 
Expressed breast milk (EBM) or infant formula can be fed to an infant by bottlePredominant or mixed breastfeeding means feeding breast milk along with infant formula, baby food and even water, depending on the age of the child. Babies feed differently with artificial teats than from a breast. When feeding from the breast, the tongue massages the milk out rather than sucking, and the nipple does not go as far into the mouth; when feeding from a bottle, an infant will suck harder and the milk may come in more rapidly. Therefore, mixing breastfeeding and bottle-feeding (or using a pacifier) before the baby is used to feeding from its mother can induce the infant to prefer the bottle to the breast. Orthodontic teats, which are generally slightly longer, are closer to the nipple. Some mothers supplement feed with a small syringe or flexible cup to reduce the risk of artificial nipple preference.


Tandem breastfeeding
Feeding two children at the same time is called tandem breastfeeding The most common reason for tandem breastfeeding is the birth of twins, although women with closely spaced children can and do continue to nurse the older as well as the younger. As the appetite and feeding habits of each baby may not be the same, this could mean feeding each according to their own individual needs, and can also include breastfeeding them together, one on each breast.

In cases of triplets or more, it is a challenge for a mother to organize feeding around the appetites of all the babies. While breasts can respond to the demand and produce large quantities of milk, it is common for women to use alternatives. However, some mothers have been able to breastfeed triplets successfully [67][68] [69].

Tandem breastfeeding may also occur when a woman has a baby while breastfeeding an older child. During the late stages of pregnancy the milk will change to colostrum, and some older nurslings will continue to feed even with this change, while others may wean due to the change in taste or drop in supply. Feeding a child while being pregnant with another can also be considered a form of tandem feeding for the nursing mother, as she also provides the nutrition for two.[70]


Extended breastfeeding
Breastfeeding past two years is called extended breastfeeding or "sustained breastfeeding" by supporters and those outside the U.S.[71]) Supporters of extended breastfeeding believe that all the benefits of human milk, nutritional, immunological and emotional, continue for as long as a child nurses. Often the older child will nurse infrequently or sporadically as a way of bonding with the mother.[citation needed]


Shared breastfeeding
Main article: Wet nurse
It used to be common worldwide, and still is in developing nations such as those in Africa, for more than one woman to breastfeed a child. Shared breastfeeding is a risk factor for HIV infection in infants.[72] A woman who is engaged to breastfeed another's baby is known as a wet nurse. Islam has codified the relationship between this woman and the infants she nurses, and also between the infants when they grow up, so that milk siblings are considered as blood siblings and cannot marry. Shared breastfeeding can incur strong negative reactions in the Anglosphere[73]; American feminist activist Jennifer Baumgardner has written about her experiences in New York with this issue[74].


Weaning
Weaning is the process of introducing the infant to other food and reducing the supply of breast milk. The infant is fully weaned once it relies on other food for all its nutrition and it no longer receives any breast milk. Most mammals stop producing the enzyme lactase at the end of weaning, and become lactose intolerant. Many humans have a mutation that allows the production of lactase throughout life and can drink milk - usually cow or goat milk - well beyond the age of weaning.[75]

In the past, bromocriptine was sometimes used to reduce the engorgement experienced by many women during weaning. However, it was discovered that when used for this purpose, this medication posed serious health risks to women, such as stroke, and the U.S. FDA withdrew this indication for the drug in 1994.[76]


History of breastfeeding
 
Famille d’un Chef Camacan se préparant pour une Fête ("Family of a Camacan chief preparing for a Festival") by Jean-Baptiste Debret shows a woman breastfeeding a child in the background.Main article: History of breastfeeding
Prior to the twentieth century, alternatives to breastfeeding were rare. Attempts in 15th century Europe to use cow or goat's milk were not very positive. In the 18th century, flour or cereal mixed with broth were introduced as substitutes for breastfeeding, but this did not have a favorable outcome, either. True commercial infant formulas appeared on the market in the mid 19th Century but their use did not become widespread until after WWII. As the superior qualities of breast milk became better-established in medical literature, breastfeeding rates have increased and countries have enacted measures to protect the rights of infants and mothers to breastfeed.


Sociological factors with breastfeeding
 The length of this article or section may adversely affect readability.
Please discuss this issue on the talk page, split the content into subarticles, and keep this page in a summary style.

Researchers have found several social factors that correlate with differences in initiation, frequency, and duration of breastfeeding practices of mothers. Race, ethnic differences and socioeconomic status and other factors have been shown to affect a mother’s choice whether or not to breastfeed and how long she breastfeeds her child.
Education According to Singh, Kogan, and Lee, more mothers with higher education levels correlate breastfeed, and these mothers breastfeed for longer.
Race and culture Singh et al also found that African American women are less likely than white women of similar socioeconomic status to breastfeed and Hispanic women are more likely to breastfeed. This may be evidence that breastfeeding acceptability is based on cultural acceptance, and that acceptance is related to socioeconomic status in the mother’s culture. The Center of Disease Control used information from the National Immunization Survey to determine the proportion of Caucasian and African American children that were ever breast fed. They found that 71.5% of Caucasians had breastfed their child while only 50.1% of African Americans had. At six months of age this fell to 53.9% of Caucasian mothers and 43.2% of African American mothers who were still breastfeeding.
Income Deborah L. Dee's research found that women and children who qualify for WIC, Special Supplemental Nutrition Program for Women, Infants, and Children were among those who were least likely to initiate breastfeeding. Income level can also contribute to women discontinuing breastfeeding early. More highly educated women are more likely to have access to information regarding difficulties with breastfeeding, allowing them to continue breastfeeding through difficulty rather than weaning early. Women in higher status jobs are more likely to have access to a lactation room and suffer less social stigma from having to breastfeed or express breastmilk at work. In addition, women who are unable to take an extended leave from work following the birth of their child are less likely to continue breastfeeding when they return to work.
Other factors Other factors they found to have an effect on breastfeeding are “household composition, metropolitan/non-metropolitan residence, parental education, household income or poverty status, neighborhood safety, familial support, maternal physical activity, and household smoking status.”


Economic factors of breastfeeding
 This article or section may contain original research or unverified claims.
Please improve the article by adding references. See the talk page for details. (July 2008)

Women who are less likely to breastfeed are more likely to incur medical bills because their babies lack the protection that breast milk provides. In the case of poor mothers this combined with the extra cost of artificial feeding could result in more debt, and even worse poverty. The birth of a child puts an economic strain on parents, but this is exacerbated if the baby is not breastfed. This is also linked to Michael Marmot’s theory of status syndrome, in which status level, determined by education, wealth, occupation, and social prestige, determines how healthy people are. Many programs have been created to help reduce the disparity between low income mothers and other mothers in choosing to breastfeed. These programs include the WIC, WHO, the World Health Organization, UNICEF, United Nation’s Children’s Fund, and La Leche League International. They work to educate women about breastfeeding and try to alleviate some of the stresses in breastfeeding in today’s society. However, according to the latest figures, WIC’s efforts have not been successful in increasing the number of breastfed infants. If these organizations had a little more success, the disparity between the socioeconomic groups could be reduced, and result in a healthier general population. Higher breastfeeding rates will not reduce the socioeconomic disparity, but it might help to increase the health of those who are poor and disadvantaged. So, breastfeeding could help to alleviate the economic stresses and poor health of the working class and the poor.

Cervical and Uterine Cancers

Completely different types of cancer affect different areas of the womb, or uterus.
The best known is cervical cancer, which affects the cervix, or neck, of the womb.
Many women, thanks to early detection, find they have abnormal cell changes in their wombs which cannot be classed as fully cancerous.

These "pre-cancerous changes" are far easier to treat, and the number of women presenting with the symptoms of cervical cancer has fallen over recent years.

However, more common is uterine cancer, in its more usual form also called endometrial cancer - which affects the lining of the womb that grows, is shed, and regrows as part of a woman's monthly cycle.

Symptoms


Samples of cells from different areas around the womb neck are taken and looked at under a microscope for signs of abnormality.

If a smear is abnormal, the woman may be asked to take a repeat smear, or, particularly if there has been more than one abnormal smear, be sent to a specialist for further checks.

Once cancer is established however, the most common symptom is abnormal (ie non-menstrual) bleeding. This is a sign that the cancer has spread to surrounding tissue.

Menstrual bleeding may be heavier and last longer.

Abnormal bleeding, particularly after the menopause, can also be a sign of uterine cancer.

Women with certain symptoms should always consult a doctor. They are:
any sort of unusual vaginal discharge
pain in the pelvic area
painful or difficult urination
Once there is a suspicion of problems, there are various techniques used by doctors to try and locate the cause.

The first is a pelvic examination, which can be carried out by a family doctor, who will check the vagina, womb, ovaries, bladder and rectum for unusual lumps or changes.

Doctors may carry out another smear test, or Pap test, to gather cells to check for cervical cancer.

A technique called colposcopy, which uses a probe to look in more detail at the cervix, is sometimes used.

The extent of any cancer discovered may be confirmed by taking a deeper slice of tissue in a biopsy.

However, if uterine cancer is suspected, either a "pipelle biopsy", in which a thin tube is used to take a small sample of tissue, or a dilation and curettage (D and C) may be undertaken. The latter, involves scraping tissue from the lining of the womb for examination.


Causes
Scientists have identified a virus which they believe may have some role in the development of cervical cancer.

The human papillomavirus (HPV), is found in most women who have developed cervical cancer.

However, most women who have the virus never go on to develop cervical cancer.

Smoking, as in so many other cancers, appears to increase the risk.

And women with HIV, the virus which causes Aids and weakens the immune system appear to be more prone.

The risk factors for uterine cancer are slightly more clearly understood.

In particular, those taking oestrogen-only hormone replacement therapies to alleviate menopausal symptoms are at higher risk. Most HRT formulations include other hormones such as progestin which appear to reduce that risk.

Overweight or obese women are thought to have more natural oestrogen in their bodies - another reason why they are more vulnerable.

Women who suffer from a condition known as benign endometrial hyperplasia, in which the lining of the womb is naturally thicker, also are more likely to develop endometrial cancer.


Treatments
If caught at their earliest pre-cancerous stage, abnormal cervical cells can be dealt with simply, using either freezing or heat to scour the cells from the cervix.

The action of the deep biopsy, called a cone biopsy, can remove a cervical cancer if it has not spread.

Depending on the spread of the disease, and the age of the woman, a number of options are available, including surgery to remove abnormal tissue or the entire womb, including the cervix.

If there is evidence of spread, then the ovaries and nearby lymph nodes are sometimes removed as well.

If the cancer has spread beyond the wall of the womb, then radiotherapy and chemotherapy may be required to try to clear the disease.

In the case of uterine cancer, it is far more likely that a hysterectomy will have to be carried out, and the ovaries may also be taken out.

If it has not spread beyond the endometrium, then surgery will probably be enough, although other treatments may follow if there is evidence of spread.

It may be possible for the woman to take HRT following the operation, although this is only likely if the cancer has been caught early.

Risk factors and causes of cervical cancer

Doctors cannot always explain why one woman develops cervical cancer and another does not. However, we do know that a woman with certain risk factors may be more likely than others to develop cervical cancer. A risk factor is something that may increase the chance of developing a disease.

Studies have found a number of factors that may increase the risk of cervical cancer. These factors may act together to increase the risk even more:
Human papillomaviruses (HPVs): HPV infection is the main risk factor for cervical cancer. HPV is a group of viruses that can infect the cervix. HPV infections are very common. These viruses can be passed from person to person through sexual contact. Most adults have been infected with HPV at some time in their lives. Some types of HPV can cause changes to cells in the cervix. These changes can lead to genital warts, cancer, and other problems. Doctors may check for HPV even if there are no warts or other

If a woman has an HPV infection, her doctor can discuss ways to avoid infecting other people. The Pap test can detect cell changes in the cervix caused by HPV. (See the "Screening" section to learn more about the Pap test.) Treatment of these cell changes can prevent cervical cancer. There are several treatment methods, including freezing or burning the infected tissue. Sometimes medicine also helps.

Lack of regular Pap tests: Cervical cancer is more common among women who do not have regular Pap tests. The Pap test helps doctors find precancerous cells. Treating precancerous cervical changes often prevents cancer.


Weakened immune system (the body's natural defense system): Women with HIV (the virus that causes AIDS) infection or who take drugs that suppress the immune system have a higher-than-average risk of developing cervical cancer. For these women, doctors suggest regular screening for cervical cancer.


Age: Cancer of the cervix occurs most often in women over the age of 40.

Sexual history:
Women who have had many sexual partners have a higher-than-average risk of developing cervical cancer. Also, a woman who has had sexual intercourse with a man who has had many sexual partners may be at higher risk of developing cervical cancer. In both cases, the risk of developing cervical cancer is higher because these women have a higher-than-average risk of HPV infection.


Smoking cigarettes: Women with an HPV infection who smoke cigarettes have a higher risk of cervical cancer than women with HPV infection who do not smoke.


Using birth control pills for a long time: Using birth control pills for a long time (5 or more years) may increase the risk of cervical cancer among women with HPV infection.


Having many children: Studies suggest that giving birth to many children may increase the risk of cervical cancer among women with HPV infection.
Diethylstilbestrol (DES) may increase the risk of a rare form of cervical cancer and certain other cancers of the reproductive system in daughters exposed to this drug before birth. DES was given to some pregnant women in the United States between about 1940 and 1971. (It is no longer given to pregnant women.)

Women who think they may be at risk for cancer of the cervix should discuss this concern with their doctor. They may want to ask about a schedule for checkups.

Do you know the difference between normal vaginal discharge and abnormal vaginal discharge? Did you know that having a vaginal discharge is normal? Let’s take a look at various types of vaginal discharges so that you’ll know when you have an abnormal vaginal discharge.

The Natural Vagina

The basic function of you vagina is to provide a route from the outside of your vagina to your uterus and the rest of your internal reproductive system. The natural, acidic, pH of your vagina acts to prevent infections. The acidic nature of your vagina is caused by natural, good, bacteria produced by your body. When your vagina is healthy, the vagina keeps itself clean and in a healthy state by producing secretions of normal vaginal discharge. The natural balance of the vagina can be disrupted by anything that interferes with its’ normal environment.
What is Normal Vaginal Discharge?
First it’s important to understand that all women experience some amount of vaginal discharge. Glands in your vaginal and cervix produce small amounts of fluid that flows out of your vagina everyday taking with it old cells that line the vagina. Your normal vaginal discharge helps to clean the vagina, as well as keep it lubricated and free from infection and other germs. A normal vaginal discharge does not have a foul odor and usually has no odor at all. Normal vaginal discharge often appears clear or milky when it dries on your clothing; occasionally you may notice white spots or a normal vaginal discharge that is thin and stringy looking.
Other things that may cause changes in the appearance or consistency of your vaginal discharge include:


Your menstrual cycle

Emotional stress

Pregnancy

Any prescribed or OTC medications you take including hormones such as in the Pill

Sexual excitement

Breastfeeding

Ovulation

Your diet

Other things that can upset the natural pH balance of your vagina and lead to vaginal infections include vaginal douches, feminine hygiene products, perfumed or deodorant soaps, antibiotics, pregnancy, diabetes, or the presence of another infection.

Do you suffer from frequent abdominal pain? Being a woman, it is quite common to feel discomfort in the lower abdomen from time to time during menstruation.

However, persistent or frequent abdominal pain can imply other health problems such as kidney problems, bowel problems involving reproductive organs like fallopian tubes and ovaries.

If you want to ensure your abdominal pain gets the correct treatment, identify the main cause behind the pain first.

Abdominal pain arising from urinary system
If you suffer from pain in your urinary system, it can indicate bladder problems such as cystitis, kidney stones or inflammation of one or both kidneys.

If you have urinary infections, you may experience burning sensation while passing urine, in addition to abdominal pain.

Pain in lower right abdomen
Besides inflammation of the bowel or appendicitis, pain in the lower right abdomen can also be caused by an ectopic pregnancy or hernia.

Bloating or swelling of the lower abdomen also represents various abnormal intestinal conditions, such as irritable bowel syndrome which causes severe abdominal pain.

Pain in navel area
If you are experiencing pain near the bellybutton, it can indicate inflammation to the appendix or a small intestine disorder.

However, despite the area or location of the pain, recurrent or persistent abdominal pain can lead to serious health problems.

Consult your regular healthcare provider to get the right treatment at the right time.
Abdominal pain is most common problem for women. Some of you can experience frequent abdominal pain and for some it can be a very rare but debilitating issue.

Before you go for appropriate treatment for abdominal pain, you have to know the cause behind it.

Here are few most common causes for abdominal pain.

Many of you can experience pain in both sides of lower abdomen, particularly during your regular ovulation period.

Regular menstrual periods or premenstrual syndrome can also cause severe abdominal pain for some of you.

If you are experiencing pain in lower abdomen during pregnancy, it can be a natural sign of pregnancy loss.

Presence of cysts or fluid filled structures in ovaries also makes you to experience debilitating abdominal pain during menstrual periods.

Parasitic infections and other gastrointestinal problems can trigger severe abdominal pain.
 
Unusual or abnormal production of mucus due to damage of certain organs of your body can also cause abdominal pain.

Urinary tract infections are most common problem among women and this could be one of the main reasons for abdominal pain in women.

Other than these, stress, tearing of abdominal muscles, peptic ulcers, and overdose of drugs or medications can lead to abdominal pain.

New Insight Into Effectiveness Of Procedure To Stop Heavy Menstrual Bleeding


ScienceDaily (Jan. 9, 2009) — Experts estimate that 20 percent of women experience excessive or prolonged menstrual bleeding at some time during their lives, particularly as they approach menopause. A new, less invasive procedure called global endometrial ablation (GEA) preserves the uterus, while decreasing menstrual bleeding and shortening patients' recovery time.


In an article published in the January issue of Obstetrics and Gynecology, Mayo Clinic researchers attempt to determine the percentage of women who do not achieve permanent symptom relief from GEA and identify several factors that put women at greater risk for this outcome.

For decades, hormone pills or hysterectomy, surgical removal of the uterus, were the standard treatments for excessive or prolonged menstrual bleeding. Although numerous studies have established the safety of GEA, some women who undergo this procedure require additional treatment or hysterectomy later because significant menstrual pain or heavy bleeding symptoms resume.
How GEA works

During this procedure, surgeons use an energy source (heat, cold and microwave or radiofrequency energy) to destroy just the uterine lining (endometrium) and leave the uterus intact. Once the cells or the tissue that line the uterus are destroyed, scar tissue forms, and monthly menstrual flow and any accompanying pain typically decrease.

Research focus

Compared to hysterectomy, the newest forms of GEA were initially thought to be equally effective with slightly lower complication rates and costs.

"We've known for the past five to six years that global endometrial ablation devices are very effective," says Mayo Clinic gynecologic surgeon Abimbola Famuyide, M.B.B.S., one of the study's authors. "But some physicians have observed that up to 30 percent of patients may require additional treatment five years and beyond after undergoing ablation."

Undergoing a hysterectomy or another treatment following ablation to achieve permanent symptom relief can be costly and inconvenient for patients. Mayo researchers note that much of the medical research citing failure rates associated with GEA had relatively small study populations and differing definitions of what constituted failure. To establish more precise, population-derived data measuring how many women do not experience permanent symptom relief following GEA, they studied the medical records of approximately 816 women who underwent ablation from Jan. 1, 1998, through Dec. 31, 2005.

"We found that only 16 percent of our subjects required hysterectomy to treat excessive bleeding five years after ablation. That is nearly half of what has generally been reported in the literature to date," explains Dr. Famuyide.

Mayo researchers hypothesized that the low failure rate they observed might mean that their study patients received counseling about realistic expectations for symptom relief. "For example, patients who are seeking complete cessation of menstrual bleeding after GEA are more likely to undergo hysterectomy later to treat bleeding symptoms of any severity," says Dr. Famuyide.

Mayo Clinic research data also showed that patients under age 45, patients who have undergone tubal ligation (a procedure to prevent pregnancy), and patients who experienced debilitating menstrual pain before undergoing GEA were less likely to experience permanent symptom relief following ablation.

According to the Mayo researchers, identifying risk factors that affect treatment outcomes following GEA is an important advance in this field. This knowledge can help surgeons determine whether GEA is appropriate for a specific patient and help them provide patients with better guidance when choosing a treatment option, say researchers.

"Optimizing preoperative patient counseling and patient selection could allow failure rates associated with GEA to decrease," explains Dr. Famuyide.

http://www.sciencedaily.com/releases/2009/01/090105175358.htm

Painful periods
The medical term for painful periods is dysmenorrhoea. There are two types.

Primary dysmenorrhoea
This term is used to describe normal period pain experienced by many women around the time of their period. There is no underlying medical problem. It most commonly affects teenagers and young women. This is the type of period pain discussed in this factsheet.

Secondary dysmenorrhoea
This term is used to describe pain around the time of the period that’s caused by an underlying problem. It is less common than primary dysmenorrhoea, and tends to affect women later in their reproductive lives.

What causes period pain?
Pains may start with the first-ever period. However, they are more likely to begin 6-12 months later, once cycles where an egg is released are established. It's these cycles that appear to cause more pain.

The cause of period pain is not certain. Once an egg has been released from one of the ovaries, natural chemicals produced by the body called prostaglandins are made in the lining of the uterus (womb). Some prostaglandins cause the walls of the uterus to contract. Some women produce higher levels of prostaglandins, which may cause increased contractions of the uterus. These cramps may be more painful because there is reduced blood (and therefore oxygen) supply to the myometrium (muscle wall of the uterus) during the contractions.


Female pelvic organs

Symptoms of painful periods
Cramping lower abdominal pains are the most common symptom. Pain can also spread to the lower back and the thighs. When severe, the pain can be accompanied by nausea or vomiting, diarrhoea, constipation or feeling faint. Some women may also get headaches.

Pain usually lasts two to three days and tends to happen in the first few days of the period, coinciding with the time of heaviest blood flow. Period pains do not cause any damage to the uterus and a pelvic examination or "internal" would show that the uterus and ovaries are normal.

Up to 15% of women have period pains severe enough to interfere with their daily activities. This can lead to missing days at school or work or decreased participation in social or sporting activities.

Period pains are often worse in adolescence and tend to improve as women get older. Many women notice that their periods are less painful after they have had a baby.

Treatment
Self-help
Over the counter painkillers such as ibuprofen and paracetamol often help. There are also painkilling tablets available that contain the drug, hyoscine (eg Feminax), that may help prevent the muscle contractions.

Moderate physical exercise can also be helpful for relieving pain, and may help prevent period pain. Many women find a hot water bottle held to the abdomen or back is comforting. Self-heating patches or heat packs that can be warmed in a microwave are a convenient alternative.

Prescribed medicines
If these measures do not provide enough relief, or if period pains are interfering with daily life, then it’s best to see a doctor. A doctor can usually diagnose period pains easily and several treatment options may be discussed.

Anti-inflammatory drugs
These work by decreasing the levels of prostaglandins. Examples include ibuprofen, naproxen and mefenamic acid. They relieve pain and can also decrease the amount of bleeding. They work best when taken regularly from the time when either pain or bleeding starts or the day before a period is due.

These drugs are not suitable for everyone – for example, people with asthma or indigestion problems may not be able to take them.

Oral contraceptive pill
The combined oral contraceptive pill, which is the most widely used type of pill, prevents ovulation (the release of an egg). This may help to decrease period pains because the lining of the uterus remains thin and fewer prostaglandins build up. It is particularly useful if a woman also wants contraception.

Mirena intra-uterine system
Mirena is the brand name of a new type of intra-uterine contraceptive device (IUCD), or coil. It differs from other coils because it releases a form of the hormone progesterone (called levonorgestrel) into the uterus. This prevents the thickening of the lining of the uterus. In addition to providing contraception, some women find that their periods become much lighter within three to six months of having the coil fitted. In a few cases the periods stop altogether. As a result of this, many women find that they also experience less period pain.

Sometimes the non-hormone releasing coils can cause or increase period pains.

Other treatments
There is some evidence that taking thiamine (vitamin B1) or magnesium supplements can help reduce period pains.

Transcutaneous electrical nerve stimulation (TENS) is another alternative. This involves a small electrical device, which is taped to the lower back. It releases tiny electrical pulses that aim to "distract" the brain from experiencing pain from the nerves supplying the uterus. It’s most commonly used for labour pains. TENS machines are usually supplied by physiotherapists, but it’s also possible to buy or hire them from local health centres, high street chemists, hospital pain clinics or branches of the National Childbirth Trust (NCT).

Some people find that acupuncture relieves certain kinds of pain, including period pain, but there is little definite scientific evidence to prove this.

Could there be another problem?
As mentioned, period pains can sometimes be the result of an underlying gynaecological condition (secondary dysmenorrhoea). A doctor should be consulted if period pains are particularly severe, or new, or are associated with any of the following symptoms:

bleeding between periods
bleeding after intercourse
pain during or after intercourse
unusually heavy periods.

 Several studies have shown that a diet rich in calcium and vitamin B6 during PMS may also help reduce water retention and alleviate bad moods. The highest sources of calcium are milk and milk products like yogurt, ice cream and cheese. But make sure you choose low-fat options. Also, you can get calcium from vegetables such as broccoli, dark greens (like turnip greens), green or red cabbage (raw), cooked collards, fish, soy products and tofu. Foods rich in vitamin B6 include bananas; baked potatoes; legumes such as soybeans and lentils; meats, especially chicken, but also beef or pork; grains and cereals with bran; and fish, especially salmon.

Some research has suggested that taking vitamin or mineral supplements may also be helpful in alleviating bloating and depression. Among the most promising of these are calcium (1,000 mg. daily), magnesium (22 mg. taken during the last half of your cycle), vitamin B6 (50 to 200 mg. daily), and vitamin E (150 to 400 I.U. daily). These recommendations may not work for all women, but the cost and risk of vitamin and mineral supplements (in recommended amounts) are low enough to justify giving them a try.

Many women have food cravings during PMS, and the cravings usually focus on sweets and snacks such as ice cream, chocolate and potato chips. Eating complex carbohydrates is probably the best way to ward off those food cravings. These foods are a good source of fiber, which helps to clear excess estrogen from your body. High levels of estrogen have been shown to contribute to PMS. Also, research has found that high-carbohydrate foods actually relieve the psychological symptoms of tension, anxiety and mood swings that accompany PMS.

Good sources of complex carbohydrates include breads, pastas, macaroni, potatoes, rice, corn and legumes such as peas, chickpeas and lentils. But remember, it takes at least two hours for the carbohydrate high to "kick in;" plan your eating and snacking accordingly, so you're not left with a case of the blahs.

In most cases, light to moderate pain and cramping during the menstrual period is considered normal and does not require a special trip to your doctor. There are things you can do at home to help yourself feel better if you experience painful periods and cramping:

Cut down on salt and sodium in your diet to reduce fluid retention

Use a heating pad or hot water bottle for abdominal cramping

Get plenty of rest

Eat a balanced diet

Take calcium and magnesium supplements during your menstrual period to help ease pain and cramping

Reduce intake of sugar and caffeine

Avoid alcohol and cigarettes

Try exercise like walking to promote deep breathing

Take a hot bath

Drink warm, herbal teas

Massage the back to relax muscles massage deep heating oils into the abdomen

For some women, orgasm brings relief by increasing blood flow to the pelvic area.

If you are having severe pain during your menstrual periods, which is called dysmenorrhea, you should see a doctor for an evaluation. It is common and can be a hereditary condition that disappears or improves after the birth of a first child. However, dysmenorrhea can also begin later in life and be caused by a disorder such as a pelvic infection or endometriosis.

Herbal remedies

Ginger: A piece of fresh ginger is pounded and boiled
in a cup of water for a few minutes. The infusion,
sweetened by sugar,is taken thrice daily after meals for
painful or irregular menstruation.

 

Lemon grass: An infusion of the grass, mixed
with black pepper is given in painful menstruation.
Raw juice or decoction of the grass may be taken in
such a condition

 

Sesame seeds: Half a teaspoon of powder of
these seeds taken with hot water twice daily acts
excellently in reducing spasmodic pain during
menstruation in young anaemic girls.

http://www.lineanegra.com.hk/

www.easyfit.com.hk