Preparing to Breastfeed: What a Lactation Counselor Wants You to Know

Breastfeeding is much like a “dance” between mom and baby

Both have to do their part—and each has to practice to triumph. The first few days of new motherhood are a whirlwind, but keep in mind that patience and repetition can help. If breastfeeding is your goal, the following are very important first steps to take just after delivery.

Kangaroo care

Right after delivery, cuddling a naked baby directly to his or her mother’s skin (preferably near the breasts) is very important. Newborns have a heightened sense of smell and use this to seek mom’s nipple. It is also proven to have other medical benefits.

An early latch

Even if baby is sleepy, try to get him or her to latch as early as possible—optimally within the first two hours.

Room in

Use the time in the hospital to get to know your baby’s feeding and diapering needs, as well as hunger cues. If baby stays in the nursery rather than in your room, nursing opportunities are often missed.

Rest

New motherhood isn’t exactly restful, but after delivery baby is often very sleepy. Use this time to rest and prepare for regular feedings.

Avoid extras

Avoid giving baby anything (pacifier, formula) other than the breast unless medically indicated. Babies are born to breastfeed and do not need anything else.

Work together

Partners can do everything except breastfeed the baby. We recommend they take care of mom, so she can focus on baby.

Lactation help

Most hospitals offer on-site lactation counseling and lactation stores, where you can get postnatal counseling, nursing bra fittings and more. If you are early in your pregnancy and your hospital does not offer these services, I would consider delivering elsewhere.


6 Heart Attack Warning Signs that are Unique to Women

It isn’t just a guy thing. Heart disease is the No. 1 killer of both women and men in the United States. 

Unfortunately, only a small percentage of women believe this is the greatest health problem facing them today. And that’s concerning, because while the overall death rate from heart disease has decreased in men, it continues to increase in women.

Coronary artery disease, or the build-up of cholesterol-containing deposits in the arteries, is one of the most common forms of heart disease. Women and men are both at risk for the disease, but women typically do not show signs until 5 to 10 years after men do.

Because nobody is exempt from heart disease, it is important speak with your physician about your risk factors for the disease (and a resulting heart attack).

Knowing the heart attack warning signs is important because early treatment can mean preventing severe long-term health problems or even potentially the difference between life and death. Just as the statistics between women and men vary greatly, so too do heart symptoms. The movies depict the traditional warning signs (which you should be aware of), such as arm pain and chest pressure or pain.

Many people, especially women, may exhibit different heart attack symptoms.

  1. Nausea
  2. Stomach, neck, shoulder or upper back pain
  3. Sweating
  4. Breathlessness
  5. Dizziness
  6. Jaw pain

Movies also falsely stereotype heart attack sufferers as older people, but heart disease can occur in people of all ages. Male or female, young or old, if you exhibit any unusual symptoms like those listed above, you should go to the Emergency Room immediately.

The 5 Most Popular Colon Cancer Screenings

Colorectal cancer is one of the most common and deadliest forms of cancer in the United States, but it has one uncommon characteristic—its ability to be detected early.

Colonoscopy screening can reduce cancer risk and detect it early, when it is most treatable. It is one of the most effective tools available to prevent cancer deaths. In fact, if caught early, colon cancer has a survival rate of nearly 90 percent. And other, effective colon cancer screenings are also available.

The Most Effective Option

1. Colonoscopy

Colonoscopy is by far the most effective and most popular screening. This is the only colon cancer screening test that can detect and remove precancerous polyps at the same time, potentially eliminating abnormal cells before they become cancerous. During a colonoscopy, your gastroenterologist can see inside the colon and large intestine by using a flexible camera called a colonoscope. It may sound a bit scary, but in the last several years the preparation has gotten easier and most patients report that the test is quick and relatively painless.

Other screenings, which can be minimally-invasive, are options for patients who may be nervous about getting a colonoscopy or for those who have other risk factors. It is important to note that the following screenings can require invasive follow-up with a positive result.

Other Great Screening Options

2. Fecal blood tests

There are two versions of this non-invasive assessment, which essentially tests for blood in the stool. Patients take home a kit to provide the sample to the testing lab or physician.

3. Stool DNA tests, including Cologuard®

Cologuard is an at-home test which examines whether there is cancerous DNA in the stool. A similar stool-based DNA test can also be ordered via your physician.

4. CT colonoscopy (virtual colonoscopy)

This is a type of X-ray that provides physicians with 3- and 4-D pictures of your colon and surrounding areas. These in-depth photos allow polyps and other abnormalities to be detected.

5. Flexible sigmoidoscopy

During a sigmoidoscopy your physician can look at the rectum and part of the colon to spot any abnormality. This type of test does not allow the provider to view the full colon, so it is less widely used than colonoscopy.

Death Rates are Declining

It is important to note that despite the availability of effective screening, death rate for colorectal cancer in adults ages 20 to 54 increased by one percent each year from 2004 to 2014. Before that time period, from the mid-1970s through the 1990s, as colonoscopy screening adoption increased rapidly, the death rate had been decreasing by almost two percent yearly. The colon cancer death rates for those over age 54 have declined, due to increased screenings in that population.

As physicians, We consider the colonoscopy to be the gold standard test. I recommend this to my family and friends. However, any screening is better than no screening at all. And that’s the truth. Talk to your physician about the screening test that is best for you. Make this brief time commitment to your health for a long-term benefit.

Are You at Risk for Developing Type 2 Diabetes?

The latest diabetes statistics show that one in three U.S. adults is at a high risk for developing Type 2 diabetes. Another 86 million U.S. adults have prediabetes, which means that their blood glucose (blood sugar) is higher than normal, but not at the level to yet be classified as diabetes. One out of 11 U.S adults has diabetes, but nearly one quarter of these adults do not even realize they have the disease. Based on recent estimates, by 2050 as many as 30 percent of U.S. adults may develop diabetes.

But Adults Are Not the Only Ones at Risk

Type 2 diabetes has also increasingly been reported in children and adolescents. Based on research by the Centers for Disease Control, as of 2015, 132,000 children and teens under 18 years old in the U.S. have been diagnosed with diabetes. The large majority, 95 percent of those diagnosed, have Type 2 diabetes.  The rise of childhood obesity and physical inactivity is widely believed to play a crucial role.

We can all work to stop this epidemic.

Diabetes Complications Can Be Very Serious

Over time, diabetes may increase the risk of serious complications including heart disease, stroke, blindness, kidney failure, amputation of toes, feet or legs and premature death. If you have already been diagnosed, or have prediabetes, keeping your blood sugar levels, blood pressure, weight and cholesterol levels within a healthy range can lower the risk of diabetes-related complications.

Prevention is Key

The good news is that diabetes is preventable. Healthy eating and positive lifestyle changes, like obtaining and maintaining a healthy weight and being physically active, are a strong defense against the development of this disease process.

https://donations.diabetes.org/site/SPageServer/?pagename=Diabetes_Risk_Test&source=dorg&cate=link&loca=alert-day.

10 Resolutions for Weight Loss

According to a University of Scranton study published in the Journal of Clinical Psychology, while 45 percent of us tend to make New Year’s resolutions, only eight percent of us actually achieve our goals. The number one resolution last year was weight loss. Quitting smoking and getting or staying fit and healthy also topped the list. Thinking big is important, but working in bite-sized chunks can make the large goals attainable.

Keep Your Goals in Sight By Breaking Them Up Into Specific, Smaller Steps

  1. Give up soda or fried food
  2. Walk or exercise five days per week, no matter the weather
  3. Drink water four times a day
  4. Park as far away from your destination as possible
  5. Take the stairs instead of the elevator
  6. Go to sleep earlier or get on a regular sleep routine
  7. Remove your television from your bedroom
  8. Don’t eat anywhere in your house outside the kitchen
  9. Give up drive-through restaurants or eating in your car
  10. Make an appointment with a registered dietitian or personal trainer

These miniature goals can serve as stepping stones toward weight loss or fitness. Once you have successfully incorporated one, and your confidence builds, plan to add another.

Changing your life isn’t easy. You may need additional, professional assistance if you have some difficulty taking these steps on your own. By working in conjunction with a health care provider, a registered dietitian or certified personal trainer can help you to stay accountable and safe.

If you have been told by your provider that you are obese, or you have a serious weight-related health concern, like diabetes or high-blood pressure, you should consider attending a health care provider-led weight loss program seminar. There are medical interventions, surgical and non-surgical, available for those who qualify.

Preventing Seasonal Allergy Symptoms

Spring has sprung and so have your sneezes

Allergies can wreak havoc on your system, causing symptoms from watery or itchy eyes to coughing, congestion and possibly even a rash. While they’ve become synonymous with spring, allergies can actually be seasonal or year-round, depending on your trigger. The first step to controlling your bothersome symptoms is figuring out what you’re allergic to.

You can narrow it down by taking note of your symptoms and their patterns. Then you can work to avoid the allergen. Below are tips to reduce both seasonal and year-round environmental allergens, including dust mites, mold, animal dander and pollens.

In the bedroom

  • Remove heavy drapes, upholstered furniture and stuffed animals that are likely to collect dust.
  • Use a zippered, plastic air-tight cover on all pillows and mattresses.
  • At least every 14 days, wash all bedding and stuffed animals in hot water and dry on hot setting.

Throughout the rest of the house

  • Avoid damp basements or water-damaged areas of your home and fix water leaks to prevent mold exposure.
  • Clean moldy surfaces with a diluted solution of bleach. If a larger-scale mold exposure is suspected, you should seek professional assistance with mold removal.
  • If possible, remove all carpets. 
  • Vacuum as frequently as possible using a HEPA (high-efficiency particulate air) filter vacuum.
  • Avoid the use of ceiling fans Prior to use, make sure to clean any collected dust from the surface of the fan blades.
  • During the height of allergy season, keep windows closed, avoid exposure to pollens and limit outdoor activities when pollen counts are highest.
    • Early morning for spring time tree pollens.
    • Afternoon and early evening for summer grasses.
    • In the middle of the day for ragweed in the fall.
  • Consider using a HEPA filter to control airborne allergens (these only work if what you are allergic to is airborne, which doesn’t include dust mites and mold).   Change the filters frequently per the manufacturer’s guide. You can also purchase HEPA home-air filters for use in your air conditioner. 
  • Since dust mites and mold increase in high humidity, keep indoor humidity low.
  • Provide a smoke-free environment for yourself and any children.
  • Cockroaches and rodents are also causes of allergies; if you suspect an infestation, make sure to clean your home frequently and thoroughly, store away food in secure containers, keep garbage outside and repair holes in the walls, floors, doors, etc.  Also, seek the help of a professional exterminator.

For those who are allergic to animal dander

  • Keep indoor pets out of the affected person’s bedroom and wash your pet each week to remove surface allergens
  • Consider a HEPA filter for the room in which the pet is primarily kept. 

If you’re unable to keep your allergies at bay with these measures, I recommend you try an over-the-counter option, such as daily salt water irrigation (Neti-Pot) combined with a steroidal nose spray (Flonase), or allergy medications, such as second generation antihistamines (Claritin and Zyrtec).

First generation antihistamines (Benadryl)  should be reserved for severe cases and should not be used as a long-term solution. If you’ve exhausted these measures and allergies are still impacting your daily life, or if you’re experiencing severe coughing, wheezing or shortness of breath, seek the help your physician. Specialized medication and testing may be for you.

When Your Bathroom Habits Aren’t Routine (And What Can Help)

Irritable Bowel Syndrome

Irregular bowel habits, alternating diarrhea and/or constipation, and cramping or bloating, in conjunction with abdominal discomfort or pain–they’re the hallmark signs of Irritable Bowel Syndrome (IBS). If you are regularly finding yourself, and your bathroom, occupied with these life-altering symptoms, relief may be in sight. 

It’s a Common Disorder

IBS can make you feel isolated, but you are not alone. It is estimated that about 10 to 15 percent of the world’s population suffers from IBS. There is no known cure for the condition, but there are many effective treatment options available.

7 ways to improve your IBS

The following can help you to manage even your worst IBS symptoms:

1. Medications

No matter your IBS symptoms, anti-diarrheal, anti-spasmodic and laxative medications can get your toilet habits back on track. These are particularly effective with patients whose symptoms do not respond to simple lifestyle changes or for those who are having severe symptoms. Low-dose anti-anxiety medications have also shown to improve the effects of IBS in some people. Communicating openly with your physician is the key to finding the best treatment plan.

2. Probiotics

They’ve become quite popular as the importance of gut health has been a popular topic in the media, but put simply, new studies have shown promise that probiotics can help to regulate the gut’s healthy bacteria and regulate you as a result.

3. Fiber

Fiber is important in any healthy diet, but for those suffering with constipation, it is particularly vital. Gradually increasing your fiber intake to the recommended 25 to 30 grams per day can help you to increase your overall health and normalize your bathroom habits.

4. Dietary changes

Fiber is just one part of a healthy lifestyle. Eating the recommended amount of fruits, vegetables and good fats daily can help your stomach and improve your mindset. While not a cure-all, the low-FODMAP diet is also worth trying if you have gastrointestinal concerns. It is an elimination diet that removes FODMAP foods, or short-chain carbohydrates, from the menu.

5. Stress reduction

IBS is often exacerbated by stress, as the mind and gut have a strong connection. Finding ways to both manage and anticipate your stress can go a long way in symptom reduction. Everything from mindfulness to yoga can help. 

6. Exercise

In a 2011 study, IBS patients who exercised 20-30 minutes per day at least three days per week saw an improvement in their symptoms. Even simple changes to your routine, like adding a 30 minute walk after dinner, can reduce your stress, improve your health and potentially erase your symptoms.

7. Education

Many patients come to me concerned that their discomfort is a sign of something much more serious than IBS. I take IBS very seriously, and I work together with my patients to find relief for their symptoms. The palliative effect of knowing their suffering is not the result of a more dire diagnosis is an added bonus. If you’re concerned about any discomfort you are having, talk with your doctor—it could be a reprieve.

When your gut feeling shouldn’t be ignored

It is important to know that IBS is defined as recurrent abdominal pain or discomfort that is associated with altered bowel habits, like diarrhea or constipation. These symptoms can typically happen on average at least one day per week for the past three months.  Symptoms such as an unexplained weight loss of more than 10 pounds, bloody stools or rectal bleeding, fevers or night sweats, or nighttime stooling are not typical of IBS and should prompt one to be evaluated by a gastroenterologist.

IBS is not an indicator of future disease

Having IBS does not increase your risk for colon cancer, Crohn’s disease or ulcerative colitis. In fact, in IBS the gastrointestinal system appears normal on an internal exam.  However, IBS is often seen in patients who have already been diagnosed with gastroesophageal reflux disease (GERD), anxiety, depression or other conditions associated with visceral hypersensitivity (fibromyalgia).

On the horizon for IBS

While there is no current cure for IBS, there are new findings about its origins. Stay tuned and in touch with your doctor for ever-changing treatment options and, hopefully, one day a cure.

It’s Too Late to Get the Flu Shot (and Other Myths)


There are many misconceptions about the flu shot, but science and experience have proven that the influenza vaccine can reduce your risk of acquiring the flu; so you can rest assured that the flu shot is generally safe and effective. Let’s tackle a few of the most common myths about this often polarizing vaccine.

A woman giving a flu shot

Myth #1: It’s Too Late to Get the Vaccine

Physicians and researchers have designed the vaccine to be most effective when it is administered before the flu begins to spread, which is typically in late October.  However, it is better to get the vaccine any point during the season, rather than not at all, as it will still protect you if you are exposed to the flu.

Myth #2: It Will Make me Sick

It’s possible to get the flu shot, then get sick the next day; it’s ironic, but the shot didn’t cause this. If this has happened to you, it is likely that you were exposed to a virus before ever receiving the shot, or you were exposed to a virus that the shot does not protect you against. The vaccine cannot make you sick or give you the flu, though side effects like soreness, redness or swelling at the injection shot, headache or low-grade fevers do occur. The vaccine’s effects have been studied time and time again, and there is no proven correlation between the flu shot and other disease or illness. 

Myth #3: It is Rarely Effective

Each year more than 226,000 Americans are hospitalized and about 36,000 die from influenza-related complications, according to the American Lung Association. But, according to the Centers for Disease Control, the vaccination reduces the risk of flu illness by 40 to 60 percent. It has also been shown to reduce the severity of illness and number of hospitalizations in those who still get sick. The influenza vaccine is designed to protect against the three or four flu strains that are most common in any given flu season. While nobody can predict fully which version of the virus you will be exposed to, the 2018-19 shot has been updated to better match the viruses that are actually circulating in the U.S. 

Myth #4: I’m Healthy, it Isn’t Necessary

Healthy or not, you are always at risk of contracting the virus. The flu can wreak havoc on your system and can also cause long-term correlative health effects. If you are in contact with children, the elderly or anyone who has an impaired immune system, you can help protect their health by getting the flu shot. In fact, every employee at our hospital is required to get the vaccine for this reason. 

If you have other questions about the flu shot, check with your physician for the facts.  From a clinical perspective, the benefit of getting the flu shot far outweighs the negatives. It isn’t too late in the season; get yours today

Is a Gluten-Free Diet Right For You?

Weight loss, loose stools, infertility, joint pain, bloating, migraines—these are only some of the varied symptoms that can result from celiac disease. For those who suffer from this mysterious illness, a gluten-free diet can be life-changing, but there is little data to prove that the diet is beneficial for the general population.

Gluten Free pastries

I would describe a gluten-free diet for the general population as a “fad” diet. It’s certainly healthy to reduce your intake of carbohydrates and accordingly consume more fruits, vegetables and lean meats, but barring celiac disease it isn’t necessary to scrub all gluten from your diet. Many celiac patients stumble on a gluten-free diet in desperation after years of living with gastrointestinal discomfort; others try the diet at the behest of their physician after diagnosis. For those with the disease the diet isn’t a fad, it is life altering. In fact, nearly all patients go into celiac remission after following the diet for one year.

The problem is celiac disease is an uncommon disease with common symptoms, which explains why it is quite elusive to many health care providers. In my opinion, increased awareness, screening and testing accounts for the rising number of people diagnosed with the disease.

If you have any of the following symptoms, or you have been suffering with unexplained gastrointestinal concerns, I recommend that you speak with your provider about testing options.

Typical Symptoms

  • Chronic diarrhea
  • Weight loss
  • Abdominal distention
  • Bloating sensation
  • Joint pains
  • Skin rash

Lesser Known Symptoms

  • Bone fractures
  • Pallor
  • Recurrent migraine headaches
  • Infertility
  • Frequent miscarriages
  • Low birth weight in children

Unique Symptoms Seen in my Office Practice

  • Iron deficiency anemia
  • Malnutrition
  • Weak and thin bones
  • Herpetic skin rash

Celiac disease is frequently associated with a variety of autoimmune or connective tissue disorders such as diabetes mellitus, hypothyroidism, ulcerative colitis, Crohn’s disease and dermatitis herpetiformis. If you also suffer from any of these diseases, it might be worth getting tested for Celiac’s.

If you plan to go gluten free, regardless of your disease status, be sure to speak to a physician or registered dietitian to come up with a diet plan that is healthy for you.

6 Things You Can do to Prevent Breast Cancer

A More Healthful Lifestyle Can Reduce the Risk of Breast Cancer

An apple a day may keep the doctor away. It might seem simple, but the truth is that living a more healthful lifestyle has been shown to reduce the risk of breast cancer, as well as many other cancers, regardless of your family history.

Be sure to talk with your health care provider, especially when it comes to how your family history impacts your risk. However, it’s been shown that moving more and eating better has a positive impact on your health and overall lifetime risk of cancer. According to the American Institute for Cancer Research, about 33 percent of breast cancer cases can potentially be prevented with some basic lifestyle changes. 

1. Lose it

Maintaining a healthy weight puts you at a lower risk for developing cancer, diabetes, heart disease and high blood pressure. If you are overweight, studies have shown that losing even a modest amount of weight (approximately seven percent of your body weight) can improve your health. Maintaining a BMI under 26, especially in post-menopausal women, has also been shown to reduce the risk of breast cancer.

2. Move

A small amount of exercise can add big results. Studies have shown that 150 minutes of exercise per week can impact weight loss. Try a new class, join a gym or simply go on a 10-minute walk after most of your meals. Find something that interests you so you’ll stick with it and start slowly to avoid injury.

3. Focus on plants

Eating a plant-based diet rich in fruits, nuts and vegetables can provide a variety of healthful antioxidants that have been shown to prevent cancer. Other foods offering cancer-reducing effects include soy, green tea, turmeric, ground flaxseed, the omega-3 fatty acids found in salmon, as well as fish oil, garlic and onions.

4. Try soy

In Asia, where soy consumption is much higher, the rates of breast cancer are much lower. It’s considered safe to consume one-to-two servings of soy per day by eating foods like tofu, edamame and protein bars. Although because soy can act as an estrogen in the body, there are different recommendations for those who have a family risk of estrogen-positive breast cancer. Check with your health care provider. 

5. Avoid fad diets and red meat

Focus on eating to maintain for your long-term health. The American Cancer Society says to avoid eating processed meats high in the cancer-causing preservative sodium nitrite. They also suggest no more than 18 ounces of “red” meat per week (pork, beef and lamb) in your diet.

6. Get drunk on life

Avoid or reduce your alcohol intake and increase your water intake. Alcohol is a proven carcinogen and contributes to weight gain. It’s recommended that women have no more than one drink per day and a maximum of two for men.

If either side of your family has a history of breast cancer before the age of 50, male breast cancer or ovarian cancer, you may be a candidate for genetic testing and you should speak to your physician about getting tested.

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