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Posts Tagged ‘pregnancy

How to choose sunscreen (at least for myself and children)?

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In mid November 2013, I read a scientific finding (by J.L. of my undergraduate almamater) that nano particles such as zinc oxide can possibly cause cancer.

Then, I feel the need to check the ingredients of my sunscreen.

SPF 15 or higher only protects against UVB, but not UVA. According to Dr. David J. Leffell (professor of dermatology and surgery at the Yale School of Medicine), the followings (ecamsule, avobenzone, oxybenzone, titanium dioxide, sulisobenzone, or zinc oxide) protect against UVA.

According to the webmd.com, children’s sunscreens use ingredients less likely to irritate the skin, like titanium dioxide and zinc oxide.

It seems that the more complicated a product is, the more hidden or unknown risks it carries.

Is zinc oxide (in sunscreen) good or bad for us?

Dr. Lawrence Gibson (a dermatologist at Mayo Clinic) views that sunscreen is safe (has not been proven to increase the risk of skin cancer, has been proven to reduce the risk of melanoma). Instead of looking at a sunscreen’s SPF, choose a broad-spectrum sunscreen that will protect you from UVA and UVB rays

If you are pregnant, avoid sunscreens that contain antioxidant retinyl palmitate, a form of vitamin A or retinol.

Sand, water, snow and concrete reflect sunlight.

Instead of being confused by the choices of sunscreen,
consider the following tips:
# Avoid the sun during peak hours (between 10 a.m. and 2 p.m.), regardless of season (Since UV light can pass through clouds, use sunscreen even when it’s cloudy).
# Choose indoor activities (e.g. indoor swim) during the sun peak hours.
# Wear protective clothing e.g. pants, long sleeve shirts, sunglasses.
# Wear a wide-brimmed hat.
# Use an umbrella.
# Vitamins. Vitamin E can protect against UV-induced DNA damage. Vitamin C helps protect skin from sunburn.
# Do not let any product lull you into a false sense of security about sun exposure.
# Finally, pursue a combinatorial approach (shade, clothing, umbrella / hat, sunscreen, common sense).

Written by blueroselady

November 14, 2013 at 7:30 am

Safety in pregnancy

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NO to caffeine.
Caffeine (found in coffee, tea, soft drinks, chocolate) readily enteres the baby’s bloodstream and accumulates in the brain.
When I knew that I was pregnant in my 1st pregnancy, I started to abstain from cofee, tea and soft drinks.

NO to alcohol. Beware of food with alcohol, e.g. tiramisu.

NO to chemicals.
Organic solvents used in dry cleaning can pass through placenta.
Pregnant women who are exposed to organic solvents at the workplace (e.g. laboratory technicians, factory workers, professionals artists / chemists) may also place their developing baby at a greater risk of developing birth defects.
Avoid chemical finishes e.g. stain repellents, flame retardants, paint / DIY products which emit fumes.
Avoid chemical air fresheners.
Avoid heavily scented cleaning products e.g. dishwashing liquids, floor cleaners, washing powders, pesticides.

NO to hair dyes / perms.
Remember that pregnant mothers are blooming beautifully, you do not need to change the color of your hair to feel beautiful.

NO to cigarette.
Avoid smokers. Exposure to as few as 2 hours a day of 2nd hnd smoke also significantly increases the risk of having a low-birth-weight baby.

NO to deep-tissue massage e.g. foot reflexology, Shiatsu.
No to sp treatments that raise pregnant mothers’ body temperature e.g. body wraps, sauna.

YES to exercise.
Walking is highly recommended for at least the 1st 2 trimesters.

When in doubt, always consult your doctor.

Related:
How to achieve pregnancy (Billings method) in the Dragon year?
Early signs of pregnancy
Challenges in pregnancy
Stay positive, be protective in pregnancy
Improve your lifestyle in pregnancy.
Checklist for week 20 scan during pregnancy.
Insurance.

Food for pregnancy:
soup of Beet root, Carrot, and Dates

Written by blueroselady

May 11, 2013 at 4:57 am

How to prevent the arrival of premature baby? progesterone

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I wrote this post few months ago.

In the 34th week, I experienced pain while walking and went to ob-gyn to do check-up.
My condition has 50% risk of delivering premature baby.
In the 35th week, I was prescribed progesterone which made me so drowsy.
I remembered how I dropped the pen I was holding half-an-hour after taking progesterone.
Then I did not feel my baby moving too, perhaps he suffered from the drowsiness as well?
As a rule of thumb, if I feel 5 baby’s movements every 2 hours, it should be ok. My ob-gyn has more lenient rule, at least 12 baby’s movements per day.

Though progesterone caused my drowsiness, progesterone helps to prevent premature baby, so it is ok to endure the short term discomfort.
The financial cost of having premature baby is large, amounting to ~$1,000 per day of hospitalization until the baby is mature.

Written by blueroselady

May 1, 2013 at 7:14 am

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How to increase breast milk production? 10 recipe of Asian soup that also benefits lactating mothers

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Category A

1. LiuWei 六味汤 + pork rib (排骨).

2. BaZhen 八珍汤 + pork rib / chicken bones*

3. SiShen 四神汤 + pork rib.

4. double-boiled chicken bones* / pork rib soup with wolfberries, red dates, xigui.

Category B

5. pork rib + overnight soaked peanut (add the soaked water to the soup) + carrots.

6. pork rib + beet root + carrots / corn.

7. pork rib / pre-boiled chicken bone (for 1 hour) + 2 potatoes + 1 carrot + 1 tomato.

8. meat ball + caixin (must finish per meal). To make meat ball, you can mix minced meat, tapioca flour, sesame oil, pepper, soy sauce.

9. pork rib / chicken bones* / pork tenderloin (腰部嫩肉) + red yeast rice (红曲米 / ang-kak)

10. fish bone + fish maw (must soak, squeeze out oil for 3x).

* use the bones of village chicken, not meaty chicken.

If you have no access to chicken bones, you can use pork rib / pork tenderloin.

Do not drink soups in Category A on consecutive days, because they may be too heaty, especially BaZhen soup.

The soups in the Category A are often consumed during confinement.
The soups in the Category B are also good for pregnancy.

The soups are easy to cook.
When mothers take good care of their health, they can give their best to their babies / children.

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Written by blueroselady

March 16, 2013 at 8:47 pm

Posted in food, health

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Do-not-eat food list (up to 100 days after giving birth)

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No prawn.
No shrimps / no dishes cooked with shrimps-based chili.
No shrimps-based chili (aka belacan).
No sashimi.
No cockles.
No cuttlefish / squid / sotong.
No crab.
No mackerel.

No unknown mixed meat^ including dim sum siu mai, har gow, mixed meat, bakwa.
No outside noodle-based food (concern about the type of oil being used for cooking).

No cabbage (because it will wash away the Chinese medicine).
No napa cabbage 大白菜.
No kimchi*.
No radish 白萝卜.
No kangkong (Ipomoea aquatica) / water spinach / water morning glory.

No watermelon.

* After 100 days, the chili in kimchi can balance the cold white cabbage, tentatively add ginger reduce the cold of white cabbage.

^ mixed meat may have neck part of pork. The old says 有毒.

Note: The list is a subset of do-not-eat food for confinement, which has more food that one should not eat according to the Eastern tradition and knowledge.

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Written by blueroselady

March 9, 2013 at 4:29 pm

My Elective Caesarean section, birth plan and FAQs

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I wrote this post some times ago, and have revised it for few times when I acquired new tips. Hope that the sharing is useful to expecting mothers with similar experience like me.

Thank you to the advance of medicinal sciences and technology, pregnant women like me have a tremendously increasing chance of survival. However, it is also possible that because of the advance ultrasound, we got the prediction that our baby was too big for natural vaginal birth, that resulted in me ending up for an elective C-section.

Good bye my birth plan for natural birth!
Initially, I wanted to have a natural vaginal birth without epidural. My paternal grandmother, maternal grandmother, and mother have delivered nine, four, and four babies, respectively, through natural birth and without epidural. I have prepared my mind to have no fear in enduring labor pain. However, since I am going for a C-section, the birth plan can be put aside for the time being.

Since my pregnancy was considered not to require C-section, no maternal obesity, no high blood pressure, no gestational diabetes, no pre-eclampsia, our baby is not in breech position, I have prepared for the best. I only read up about natural birth, we watched videos about natural birth but not Caesarean at all. OK, I read a little bit about Caesarean.

Our baby was underweight all the way, then he started to have normal weight. That’s good. Then, in the last 2 weeks, he gained about 0.5 kg per week. Well, our baby is a late boomer.

On my 39th week 3rd day (in the evening), the ob-gyn recommended me to go for an elective Caesarean the next day or the day after. We did not have any mental preparation.

The C-section was scheduled 2 days before our baby’s EDD (expected due date). Until the day before the C-section, I had no major contraction, no bloody show. I only suffered from back pain from growing tummy, and could only sleep on left side, with a little pillow to support my belly (with baby inside).

Since the operating theaters were not available the next day after we saw the ob-gyn, I had a day extra to find out more about C-section.

To quote Marie Curie, "nothing is to be feared, only to be understood." I think and feel that the more I understand, the more prepared I will in facing challenges in lives. That is what happened when I prepared myself mentally and physically for tandem skydiving, paragliding, many academic examinations in the past, delivering talks, and venturing into the foreign countries on my own. In addition to my birth country where my parents took care of me, I have lived and survived on my own in five foreign countries, learning the systems from the scratch, making new friends, finding ways to my accommodation. To learn about making peace, I have also traveled to war torn site where soldiers with gun pointed at our bus. I have nothing to be fearful of except God.

In the evening we saw the ob-gyn, we decided to follow the ob-gyn’s advice. He told us that he was worried that the baby may have shoulder dystocia or injured nerves as he might be too big to pass through my birth canal. The ob-gyn even did not bother to check if my cervix was dilated. Shoulder dystocia affects less than 1% of birth, but our baby might have an increased risk.

As of the 39th week 3rd day, our baby has not reached the criteria of macrosomia (big baby syndrome). Note that fetal weight estimations late in pregnancy are pretty imprecise.
Perhaps, the ob-gyn thinks that our baby is big, I am small (though not small by Asian standard). I still remember my Spanish girlfriend remarked that I looked slim while pregnant, without a big belly. She teased me "I hate you". Well, now my belly looks big, I agree with the ob-gyn that our baby is likely to be a big size but I was hopeful that I can deliver him naturally.

The ob-gyn prefers the election C-section instead of an attempt of natural labor followed by emergency C-section with high risk in between. Emergency C-section has increased risk of surgical and anaesthetic complications. Post-surgical remark : I think my anesthetist was cool! He estimated the right birth weight of our baby with a difference of 0.002 kg. I may consider anesthetist as a career, if I had a chance to go to a medical school.

For the safety of our baby, we consented for an elective C-section. It was difficult to book an operating theater at our hospital of choice, they seemed to be unwilling to give us a slot, until the ob-gyn personally spoke to the hospital staff. The latter thought that we chose an elective C-section for horoscopic purpose. Actually, we did not care about the timing, as long as our ob-gyn feels comfortable and not in rush, of course we understand that he wants to see patients at his clinic at particular time slots. The most important thing is the safety of our baby. When I tried to think positively about the hospital, I come out with a positive explanation (as advocated by Martin E. Seligman): they perhaps reserve the operating theater for emergency C-section for mothers who have not succeeded to try to deliver naturally.

"My attitude is Que sera sera. Accept things that I cannot change. Now, we can only make decisions based on our limited knowledge."

Our baby was still moving happily in my womb on the day -1 of C-section. Soon, I will be able to see and hug the little one whose tiny feet and knee often protrude on my belly. However, I was concerned with the slower recovery from C-section, how I was going to take care of our baby. Post-delivery note: it turned out to be a huge challenge! Since my left hand was poked with medication, I have no strength to bring my baby to my side to breastfeed him.

FAQs (note: you should always consult your healthcare provider):

Q Why did our baby suddenly grow so much?
1. Since I complained about abdominal pain and my cervix was relatively short as compared to normal, I was prescribed 200 mg of Utrogestan daily to prevent premature delivery, for a period of 2 weeks (until the safe date for our baby’s birth). I did not took it for the last 2 days of prescriptions. I was also asked to rest more, which I enjoyed as I love reading, gazing at the park nearby, and freed me from the need to commute to work. I love to work, but I find that fighting for a space in public transport is like a daily battle and I had to be extremely careful of irresponsible people who run to rush for the train.
2. Honestly, I ate some chocolate cakes, though I do not think that I ate excessively based on my normal weight gain. The ob-gyn told me that my baby weight has nothing to do with my diet.

Q: How do I know if our baby is really big?
A: A friend had a baby measured using ultrasound for 3.5 kg, but the baby girl arrived weighting only 2.8 kg. That is why they said that the ultrasound weight prediction is imprecise. Both father and mother of our baby are not fat genetically, how can our baby be so big? Perhaps he is lengthy, and the weight measurement of ultrasound is based on the length.

Q. If I have a short cervix, will it be a shorter path for our baby to pass through, then why I cannot attempt a natural vaginal birth?
A. In my consent form, the reason for elective C-section is Cervical dystocia.
What is cervical dystocia? difficult labor and delivery caused by mechanical obstruction at the cervix.
I also read that "In preparation for childbirth, the woman’s cervix shortens."
I am confused.
No matter what, we are grateful that our baby did not end up as a premature baby.

Q: How do I know my cervix is dilating?
A: " if my cervix was in fact dilated, then I’d be able to feel something hard on the other side of it"
www.babycenter.com said that a pelvic exam can result in too much stimulation and more dilation of cervix.
Self-check may be dangerous / unhygienic, risk of breaking water bag, feel for the "hole in the donut".
"you could go 3 weeks more without going into labor after you have become effaced or started dilating"

Q: Does short cervix cause cervix dystocia?
A: I cannot find answers to this.

Q: Is C-section less painful than natural birth?
A: No, this is a misconception. The pain that is experienced because of surgery is greater than that of labor and therefore requires a more intense nerve block. It seems that I was going to endure more pain but the effect was minimized through anesthesia, but for the subsequent days I had to endure more pain as compared to natural birth.
It seems to me that
natural birth: short-term severe pain, long-term mild pain.
C-section: short-term mild pain, long-term severe pain (with the risk of longer recovery).

Post-surgical note : I heard that some women opt for elective C-section to preserve their vagina, in order to keep their husband happy.

Q: What are the risks of C-sections?
A:
postoperative adhesions.
incisional hernias: may require surgical correction.
wound infections.
placenta accreta.
emergency hysterectomies.
postnatal depression.
newborn mortality before 39 weeks.
C-sections for subsequent pregnancies & deliveries.
Emergency C-sections have additional risks:
anaesthesia risk: due to stomach not empty.
severe blood loss.
postdural-puncture spinal headaches.

Q: Will C-section reduce the chance to conceive / have the subsequent baby?
A: There will be an increase risk of
1. placenta accreta (only 0.13% after two Caesarean sections, but increases to 2.13% after four and then to 6.74% after six or more surgeries).
2. emergency hysterectomies.
40% or more of women having three or more C-sections will experience the complications of heavy bleeding and needing hysterectomy.
"By the time a woman gets to her third cesarean, she’s at serious risk for life-changing and even life-threatening complications," says Bernstein.

Q: Can one have a vaginal birth after a previous C-section?
A: Yes, but there will be a risk of uterine rupture which is catastrophic. We had a heart-to-heart discussion and decided that we are happy with 2-3 children, even if just 2 children.

Q: Should I choose between GA (general anaesthesia) or epidural?
A: Regional anaesthesia (e.g. using epidural) is preferred as it allows the mother to be awake and interact immediately with her baby.
You may still feel some pressure or a tugging sensation at some point during the surgery.
A catheter is then inserted into your urethra to drain urine during the procedure, and an IV is started (for fluids and medications including antibiotics) if you don’t have one already.

Q: Does one have to shave for C-section?
A: The top section of your pubic hair may be shaved (http://www.babycenter.com). My ob-gyn prefers full shave.

Q: What are the types of C-section, their pros and cons?
A:
1. VERTICAL / Longitudinal incision. Con: more complication. Pro: more space to deliver baby. Used in emergency C-section to allow a quicker access to baby.
2. HORIZONTAL / lower uterine segment section / a transverse cut just above the edge of the bladder. Pro: less blood loss.
The procedure involves an incision through the skin, abdomen, muscle, and then into the uterus. From start to finish, including pre- and post-op, a typical C-section lasts 3-4 hours.

Q: Should I request for antacid medication?
A: You may be given an antacid medication to drink before the surgery as a precautionary measure. If an emergency arises, you may need general anesthesia, which puts you at risk for vomiting while you’re unconscious and inhaling your stomach contents into your lungs. The antacid neutralizes your stomach acid so it won’t damage your lung tissue.
For me, since I suffered from gastric pain in the past, I would prefer to request for an antacid.

Q: Can my birth partner attend C-section?
A: Your partner, freshly attired in operating room garb, may take a seat by your head.
Sometimes no for emergency C-section, in which GA is used.

Q: What Bible verses can help to prepare Christian mothers for C-section?
A:
2 Corinthians 12:9,10 "My grace is sufficient for you for my power is made perfect in weakness. … For when I am weak, then I am strong."
Psalm 103:1-5 "… who forgives all your sins and heals all your diseases, who redeems your life from the pit and crowns you with love and compassion, …"
Proverbs 31:10-31 "A mother’s love is like a beacon burning bright with faith and prayer. Through the changing scenes of life, we can find a haven here. A mother’s love is something that no one can explain — it is made of deep devotion and of sacrifice and pain."

Q: How expensive is C-section?
A: Caesarian is $500 + $925 = ~ $1,500 more expensive than normal delivery.
Note that this calculation has not included:
room charges.
equipment usage fee.
medication fee.
anesthetist fee.
baby’s stay.
pediatrician fee.
doctor’s daily visits (even just to ask "are you ok?").
Eventually, several thousands $ are required.
Personally, I try to save money by sharing a room. I can still have privacy of view thanks to the curtain, but patients have limited privacy of sound. My first night roommate heard my family’s and relative’s conversations, and by default I have to listen (& get to know my second and third night roommates because some (I think many of) their relatives speak loudly). An ear plug is a rescue.

Q: How is placenta removed during C-section?
A: The ob-gyn will do it.

Q: How is the suture done?
A: The stitches used for your uterus will dissolve in the body. The final layer – the skin – may be closed with stitches or staples, which are usually removed three days to a week later (or your doctor may choose to use stitches that dissolve on their own). Closing your uterus and belly will take a lot longer than opening you up, usually about 30 minutes.

Q: How to breastfeed after C-section?
A:
1. you and your newborn lie on your sides facing each other.
2. football / rugby position.
To minimize discomfort, place a pillow over the incision while holding your baby.

Q: How is lochia removed after C-section?
A: According to Mayo Clinic, “Expect a bright red, heavy flow of blood for the first few days after the C-section. It might contain a few small clots. The discharge will gradually taper off, becoming more watery and changing from pink or brown to yellow or white. To reduce the risk of infection, use sanitary napkins rather than tampons. Contact your health care provider if your bleeding soaks a sanitary pad each hour for two hours, you pass a clot larger than a golf ball, the discharge has a foul odor, or you have a fever of 100.4 F (38 C) or higher.”

Q: How to recover from C-section?
A:
As soon as the anesthesia wears off, your doctor will encourage you to get up and walk around, which reduces the risk of a dangerous blood clot (pulmonary embolism) forming. Post-surgery note: I only remember a voice telling me to move my legs after the surgery, even though I was immobile.
Avoid strenuous work (e.g., lifting objects over 4.5 kg, running, walking up stairs, or athletics) for up to six months.
Rest as much as you can.
Talk less.
Wait ~ 18 months before attempting to conceive another baby.
According to babycenter, pee often, even if you don’t feel the urge to go. In the first few days after you give birth, your bladder may be less sensitive than usual, so you may not feel the need to urinate even when your bladder is quite full. In addition to causing urinary problems, a full bladder makes it harder for your uterus to contract, leading to more after pains and bleeding.

Q: What are food precaution after C-section?
A: My mother: do not eat hard food (e.g. rice) immediately after surgery, but drink something warm or eat porridge. If the porridge is cold, do not eat.
Do not eat TianZiWang.
Do not eat fried food.
My mother in law: do not to eat poultry within 12 days after C-section because today poultry is heavily injected with hormones.
My confinement lady: Do not eat ginger and wine within 12 days after C-section.
My confinement lady: Do not do post-natal abdomen massage, but hand, foot, back massage are ok after 12 days of delivery. A friend A of CW who also delivered via emergency C-section went for the post-natal abdomen massage, and felt uncomfortable after it. Personally, I think foot massage has risks too because of the linkage of acupressure points.
See also my notes on confinement.

More details:
www.webmd.com
www.mayoclinic.com
www.babycenter.com

Things I did on day -1 of my elective LSCS:
Read, watched, learned about C-section.
Drank a lot of water because I felt so thirsty.
Drank red date tea.
Paid all my outstanding credit card bills. I did not know how long it would take me to recover.
Requested the father of our baby to help us take photos of my tummy with the baby at the park.
Trimmed my eyebrow and fringe.
Clipped my nails to prevent scratching our baby.

New birth plan for my elective lower segment C-section (LSCS):
To ask healthcare provider:
Will my IV contain antibiotic?
Will I be given antacid? to request.

Before I head into the operating room, let my doctor know that I would like to see our baby as soon as possible after the delivery (as long as he is healthy).
Tips: if you have myopia, you will not be allowed to wear your soft lens, so bring your spectacles with you (and do not let any nurse to take them away). If they insist, pass it to your birth partner. Like me, you want to see your baby clearly.

If the ob-gyn allows, ask the father of our baby to play soothing music. Post-surgical note: I forgot to request. Then, I tried to console myself that music may distract my ob-gyn.

After C-section, to confirm with the ob-gyn if I do not have vertical incision.
If there was vertical incision, uterus is more likely (8 – 10%) to rupture during a vaginal birth after cesarean (VBAC).
Note: outside incision may be horizontal, but invisible inside incision may be vertical.
My ob-gyn said I have horizontal incision.

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Written by blueroselady

March 8, 2013 at 11:07 pm

How to prevent the arrival of premature baby?

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1. No sex.
2. Do not wash vagina with chemicals.
3. No caffeine. No ginseng, red date tea, barley tea, danggui as they constrict womb. If possible, no chocolate.
4. Do not sit or stand for too long. Although walking helps delivery, if you have high risks of premature delivery, do not walk too much.
5. Keep track of baby motion. What is the number of times your baby should be moving daily between breakfast & dinner in your 3rd trimester? 10.
6. Reduce stress.
7. Be safe. Protect yourself from collision. Be careful of reckless drivers, cyclists, roller-bladders / skateboarders, children playing football at non-designated areas.
8. progesterone.

Sources:
Mom Baby / Mama Baobei magazine (2012Jan) p101.
Mother&baby 2012Jun p18.

Written by blueroselady

January 2, 2013 at 10:02 am

Posted in health

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