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A new study conducted by Kaiser Permanente in California, and published in the American Journal of Obstetrics and Gynecology, shows a link between caffeine consumption and miscarriage risk. The study looked at over 1000 women, they were interviewed at an average of 10 weeks into their pregnancy. 16% of the women were found to have miscarried. Of those who miscarried, 60% of them had consumed up to 200mg of caffeine everyday, with another 15% saying they consumed more than 200mg of caffeine daily. By contrast only 25% of the women who miscarried had reported not consuming any caffeine.
Several studies have been conducted to determine the effect of caffeine on early pregnancy, however, previous research studies did not control for morning sickness (which often results in a reduced risk of miscarriage). In this particular study they did control for morning sickness and found an increased risk of miscarriage based on caffeine consumption even among those women who reported having morning sickness in early pregnancy.
Not a lot is known about why caffeine causes an increased risk of miscarriage, however, it is thought that since caffeine crosses the placenta is affects cell development and may even impact the blood flow from mom to baby.
Doctors have long cautioned women against consuming too much caffeine during pregnancy, but didn’t really know how much was too much. The results of the study seem to indicate that any amount of caffeine increases the risk of miscarriage, but that 200mg or more causes the greatest increased risk. 200mg of caffeine is equivalent to 2 cups of coffee, 4 caffeinated sodas, or 4 cups of tea.
I wasn’t a caffeine drinker before my pregnancy so it was easy for me not to consume any caffeine during my pregnancy. Women who rely on caffeine to get them going in the morning are likely to have a harder time staying away from or reducing the amount of caffeine they consume during pregnancy. A few things you can do to combat the exhaustion of the first trimester without turning to coffee are: get enough sleep (nap more, adjust your schedule so you can sleep more, etc), eat a healthy, balanced diet, and exercise.
Talk to your doctor about the results of this study and determine what you can do to reduce your own risk for miscarriage.
Breastfeeding is best for your new little bundle of joy. The American Academy of Pediatrics advocates exclusive breastfeeding for the first six months of life and continued breastfeeding through one year of life. My own experience has been that once you get the hang of it breastfeeding is pretty easy and seems to make life with a new baby pretty manageable, no bottles, less mess, more mobility. However, breastfeeding is not for everyone. Some women are unable to breastfeed for health reasons, some babies are unable to take the breast for health reasons, and sometimes it is just a personal choice not to breastfeed.
Bottle-feeding is a healthy alternative and the formulas on the market today are pretty good according to the lactation consultants and pediatricians I have talked to. They are definitely not the “real thing” (breast milk), but they do a good job of ensuring your baby is getting a good start to life. Talk to your pediatrician about the best formula for your infant. You may find that you need to try a couple of different ones before you find one that works best with your baby’s system.
So if you do choose, or just somehow end up, bottle-feeding your baby what are the basic things you need to know. This is also good information for parents who are introducing their breastfed baby to the bottle either because you are returning to work or just want to have the freedom to have someone else feed the baby occasionally.
How often should I feed a bottle fed baby?
As with a breastfed baby feeding should not be on a rigid schedule in the early weeks of life. Feed your baby on demand and let them figure out the schedule. Talk to your pediatrician about how much to feed your baby, it will depend greatly on the baby’s age and weight. Don’t try to feed your baby more than they are willing to take. Babies are pretty good at knowing when they are full.
Do I need to sterilize the bottles?
It is important to sterilize the bottles before you first use them. Be sure to sterilize all parts of the bottle. After that you can usually get away with just a good cleaning in hot soapy water after each use. Of course, it doesn’t hurt to sterilize the bottles occasionally just to be safe.
Do I need to sterilize the water I use to make the formula?
Talk to your pediatrician about this. If you have a good city water supply in your area you likely will not need to sterilize the water, regular tap water will work just fine. However, if you use well water or there is some issue with your city water supply your pediatrician may advise you to sterilize the water.
How should I warm the bottle?
It isn’t necessary to warm a bottle before giving it to your baby, but you may find that your baby prefers it to be warm. This is particularly true when giving a bottle to a breastfed baby. They are used to the warm milk from your breast and may need the breast milk or formula in the bottle to be warm before they agree to take the bottle. The safest way to warm a bottle is to place it in a warm bowl of water. Never use the microwave and be careful that the water you are warming it in is not too hot. Before feeding a warmed bottle to your baby be sure to test the temperature of the liquid to avoid burning your baby.
What is the best position for feeding the baby?
Bottle fed babies are often more gassy than breastfed babies as they take in more air during the feeding. The best way to feed a bottle fed baby is with the baby sitting slightly upright, about a 45 degree angle. This will help avoid too much air getting in with the formula or breast milk. Your baby may determine a position that they like best, so pay attention what seems to make the baby happiest and go with that.
As with everything about baby care you’ll learn the tricks that work best for your baby as you go along. Anytime you have questions or concerns about bottle-feeding talk with your pediatrician.
One tip I can give you from my personal experience is to not stock up on one particular type of bottle when you are out purchasing your baby feeding gear before the baby is born. It would be a better idea to purchase one of a couple of different types of bottles and then figure out which one your baby likes best. I had to try a couple of different types of bottles before I found one that worked best for my daughter.
Having a baby is a lot of work for your body and it takes time for things to return to normal and for your body to heal from the effects of labor and delivery. Your doctor will want to check up on you again a few weeks after you deliver to make sure everything is OK.
If you had a normal vaginal or cesarean delivery you will likely see your doctor about six weeks postpartum. This visit is necessary so your doctor can make sure that you are healing well, everything is returning to normal with your body, and emotionally you are doing OK. When your doctor wants to see you back in his or her office may vary, particularly if you need stitches or staples removed or you had any complications with your delivery. On average though you can expect to be back in the doctor’s office four to six weeks after your baby is born.
At this postpartum visit you can expect a few things. Of course, just like with your prenatal visits, your doctor may do things a little differently or you may need something different because of a special circumstance either with your delivery or your postpartum recovery. The typical postpartum follow up appointment will include:
- Your doctor will ask you several questions about your postpartum recovery including:
- how long after delivery you experienced vaginal bleeding
- if you are still having any kind of vaginal discharge
- if you are still experiencing any discomfort in you vaginal or rectum area (this can be particularly important if you had a tear or an episiotomy)
- if you are feeling OK emotionally (he/she is checking for signs of postpartum depression)
- determine if you have any questions about your postpartum recovery
- Your doctor will examine you to ensure that your uterus is returning to its normal size and that your cervix has healed. This will involve an internal examine.
- If you had a tear or an episiotomy your doctor will examine that as well to make sure it is healing well. If any stitches remain he/she may cut those out, they are designed to dissolve but if they aren’t buried well enough in the skin they may not.
- Your doctor will examine your breasts to check for any signs of clogged milk ducts, infections, or other problems common in breastfeeding moms.
- At this appointment your doctor will discuss with you whether it is OK to begin having sexual intercourse again or not. If your tear/episiotomy is still healing you may need to wait a little while longer, but otherwise it is typically OK to begin having sex again after six weeks. Your doctor will discuss what forms of birth control are OK at this point.
- If you delivered by cesarean section your visit will be similar to that of a woman who delivered vaginally, of course the incision for your cesarean will be examined as well.
If you have questions or concerns about anything this is the time to talk to your doctor about them as it may be a while before you are back in his or her office. If you are feeling sad or depressed don’t be afraid to say so. Your doctor is there to help you and will be able to work with you to control any postpartum depression you may be suffering. If you feel like you need to see your doctor sooner than planned call his or her office.
Suffering a miscarriage can be devastating and it can be difficult to make the decision to try to get pregnant again. Depending on the cause of the miscarriage and when it occurred in your pregnancy will play a big role in determining when it is ok to try to get pregnant again. However, how you feel emotionally plays an even bigger role. Once your body, mind and heart have healed from the loss of the previous pregnancy (and you have cleared it with your doctor) you can begin trying again. Becoming pregnant again will bring a mixed bag of emotions for you from being truly happy to sad about the fact your last pregnancy wasn’t successful.
Being pregnant again after a miscarriage maybe a little scary. It is hard when you have gone through a miscarriage not to worry that the next pregnancy will end the same way (particularly if you have suffered multiple miscarriages). You may be constantly thinking about it and afraid to do anything for fear it will cause you to miscarry again. Be sure to talk to your doctor about your fears. You may find it comforting to have more frequent appointments with your doctor until you feel like you are “out of the woods”. Reaching the point in your pregnancy where you miscarried previously will be a big step and you will likely find that you feel much more secure with the pregnancy and little more at ease once you get to that point.
When you become pregnant again after suffering a miscarriage remember to stay positive, talk with your partner about your fears and worries, talk to your doctor about any concerns you have, keep on top of your health (both physical and emotional). It can be difficult but try not to worry too much. You may find it helpful to join a support group so you can talk with other women who are in a similar situation. Sometimes the best medicine is knowing that you are not alone.
Finding a good babysitter can be quite the chore. If you have friends who have children you can get recommendations from them, you can rely on family members to take care of your kids (but that doesn’t necessarily translate into a good babysitter), or you can find a referral network in your community to find a babysitter. No matter how you find your babysitter though you will never know for sure if they are good until you try them out. Of course you can interview them to weed out the ones that are obviously not cut out for the job but that only goes so far.
So how do you tell if you have a good babysitter or a bad one? Here are a few tell tale signs.
Signs of a Good Babysitter:
- Your child is excited to see the babysitter and just seems to light up when they see them. If your child likes to be with the babysitter it is a good sign that they are doing something right.
- Your child can’t stop talking about all the things she does with the babysitter.
- The babysitter makes an effort to stay connected by completing an activity log or through open communication with you before and after they take care of your child.
- There is evidence of activities your child has done such as art work, toys being out, etc.
- The babysitter is open to your requests and makes an effort to follow them.
- The babysitter is always on time and appears excited and happy to be there.
- Your child is clean and appears well taken care of when you get home.
Signs of a Bad Babysitter:
- Your child is not excited to see the babysitter or becomes upset or uneasy when you talk about the babysitter.
- The babysitter is often late and doesn’t appear very interested in your child.
- There is little communication from the babysitter about what they did while you were gone or she can’t answer questions about what they did that day.
- Your child appears unkempt, messy, or neglected when you get home.
- Your child has many unavoidable accidents.
- You just don’t feel comfortable with the babysitter.
Finding the right babysitter can take time. You will often have to try the babysitter out before you will know if it is the right match for you and your child. Sometimes a person can be perfect when your child is small but as they get older they are no longer the right match for the job.
What did you do to find your babysitter? Did you have to interview a lot of people before you find the right one? What things do you particularly like about your babysitter? Have you had any really bad experiences?