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]]>Women, especially those who have invested in breast augmentation, are often worried about changes in their breasts due to breastfeeding, the researchers said. But a study of 119 women with breast implants suggests no cause for additional concern.
“Breast sagging, often experienced after childbirth, results from changes brought about by the pregnancy itself, not breastfeeding,” said study author Dr. Norma Cruz, a professor of plastic surgery at the University of Puerto Rico School of Medicine in San Juan, in a press release. “Breastfeeding does not appear to further cause breasts to sag in women who’ve had breast augmentation,” she said.
The research evaluated the changes in breast measurements resulting from pregnancy in 57 women who had breast augmentation and breastfed and those among 62 women with breast implants who did not breastfeed.
Measurements were taken both before pregnancy and one year after pregnancy or after completing breastfeeding. Findings showed that changes in breast measurements and the degree of sagging weren’t significantly different among women who breastfed and those who didn’t.
Although breast measurements and sagging did increase among the women, Cruz said that this was because of changes related to pregnancy, not nursing.
“A similar study in women without breast implants found that breastfeeding was not a significant risk factor for breast sagging,” she added. “Since breastfeeding improves both a mother and child’s overall health, patient education on this issue is of importance.”
(AFP Relaxnews)
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]]>The post Perineal tear: The lowdown on tearing down low! appeared first on All4Baby.
]]>When baby’s head crowns during childbirth, the tissue around the vaginal opening can tear. Typically, tears range from mere skin snicks which heal on their own after childbirth (called first-degree tears), to tears involving vaginal tissue and the perineal muscles, which will need a few stitches in the delivery room (second-degree tears). Far more rare are third- and fourth-degree tears, involving the vaginal tissue, perineal muscles, anal sphincter and at worst, tissue within the rectum. These tears require repair in theatre.
Understandably, moms delivering vaginally are often concerned about the pain of tearing. The good news is that you are unlikely to feel the tear during labour, since the skin is stretched taut, making it quite numb.
Afterwards however, pain will vary depending on the severity of the tear; in most cases, since the majority of tearing is either first- or second-degree, moms report stinging rather than actual throbbing pain.
The only delivery where a wound is a certainty is a Caesarean section. For a natural birth, the chances of going home with a tear are significantly smaller: around 40% for first-time moms, and 20% in subsequent deliveries, with only 0.6%-0.9% of vaginal deliveries resulting in a severe tear, according to James, Steer, Weiner and Gonik in “High Risk Pregnancy Management Options” (2005, Saunders Elsevier).
Baby’s size and position during the birth have a big influence. Babies who are large for their gestational age or over 40 weeks are more likely to cause tearing. Risks also increase with babies born face first or facing mom’s front instead of her back, and with those who have a hand, elbow or shoulder protruding.
Mom’s position during delivery is another factor. The rate of perineal tearing is higher in a traditional hospital environment where moms are required to deliver on their backs, often with their legs in stirrups; this is a particularly bad position for tear prevention.
Medical intervention also significantly raises the risk, with forceps delivery probably the biggest culprit. Epidurals also have an impact, since they stop moms feeling the urge to push. Moms often end up pushing too early which can lead to a prolonged second stage of labour – a known risk factor in tearing – or they push too hard before the perineum has stretched sufficiently.
An augmented labour, where labour is helped along by drugs, further ups the risk. Contractions are often stronger than normal, which can cause the baby to crown too early and quickly.
This used to be the accepted thinking, but experience has shown that episiotomies, where the perineum is cut by the doctor or midwife, do not reduce the severity of tearing. In fact, an episiotomy increases the risk of having a more severe third- or fourth-degree tear. Just think how hard it is to tear material, yet if you make a little nick, the fabric rips easily; the same happens with an episiotomy.
A perineal tear is usually only superficial, running through the skin, whereas an episiotomy cuts right through skin and muscle. This means episiotomies are usually more painful and slower to heal since they’re much deeper. The ragged edge of a natural tear is easier to match back if stitches are needed, so the wound heals with less scarring.
Episiotomies are only necessary in emergency situations when your baby needs to come out immediately, and there is no time to allow the perineum to stretch naturally.
There is no way to guarantee that you won’t experience some degree of tearing during birth, but there are a number of ways to minimise the risk.
Second-degree tears will be stitched by your doctor or midwife under local anaesthetic, while third- and fourth-degree tears will be repaired in theatre.
Good wound care is important; ice packs will help reduce swelling and discomfort. Keep the area clean and don’t fiddle with the wound; salt baths are a great way to disinfect your wound while easing the discomfort.
If the wound stings when you go to the loo, pour warm water over the area while you urinate. You can also take stool softeners if it’s painful when you have a bowel movement.
How you decide to have your baby is your personal choice, but remember that whether natural or by Caesarean, there is no pain-free, risk-free way to get a baby out of your body. Neither birth routes are without risks; both have their own set of associated problems which you should take into consideration.
While you’re weighing up your risks of getting a bad perineal tear, also weigh up your chances of having an infected C-section incision that will require surgical repair, which happens in around 4-8% of Caesareans. And while you might be caring for a wound if you give birth naturally, you’ll definitely be caring for one after a Caesarean.
For more information on Genesis Clinic, visit www.genesisclinic.co.za
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]]>The post Worried about breastfeeding? Don’t be! appeared first on All4Baby.
]]>Despite your good intentions though, you might be worried that you won’t be able to breastfeed. You’ve heard other moms talking about breastfeeding, about why they stopped, or why they didn’t even try in the first place. And all that talk can damage a new mom’s self-confidence.
When new moms hear the reasons many women give for not breastfeeding, it’s easy for them to start thinking that women’s bodies routinely malfunction, and that being able to breastfeed is just a question of genetic luck … ‘She has the right kind of boobs, lucky her’.
This is also why, at the first sign of difficulty, many new moms give up prematurely, thinking that they too must be on the path to failure. On the contrary though, had she only persevered, mom and her baby would have reaped the many benefits – both physical and psychological – of breastfeeding.
More women are physically able to breastfeed than are not. Consider that in Bangladesh, 98% of moms breastfeed, while in Norway, 95% of moms breastfeed – these are good indicators of women’s actual breastfeeding abilities.
The message is that if you have chosen to breastfeed your baby, you need to trust yourself and your body. Don’t let others’ often-misinformed reasons for not breastfeeding derail the vision you have for yourself and your baby.
Here are some of the reasons new moms give me for why they aren’t breastfeeding, and why these reasons shouldn’t put you off:
This is probably the number one reason I hear, especially in the first weeks after delivery, yet the vast majority of women will produce enough milk to nourish their babies if they follow good breastfeeding practice.
Moms often think they don’t have enough milk if their babies suddenly start fussing more than usual, or feeding more frequently, or popping off the breast sooner. Another red herring is the breast pump. After a mom has managed to pump only a few millilitres, who can blame her for concluding that she has no milk supply, when in reality she likely has an abundant supply? That’s because there’s nothing like a real baby to stimulate milk letdown.
Remember that breastfeeding is a supply-and-demand situation. Demand feed your baby, and your body will up production. Skip a feed or two every day and your body will respond by reducing the supply.
Your baby doesn’t understand your schedule, so put aside your need for control and order, and let your baby decide the schedule. Babies want to feed when they’re hungry, not when you and some baby-raising book say it’s mealtime.
If your baby is gaining weight, seems reasonably content, is alert, and produces five or more wet nappies, and two to five poo nappies a day from day four, put your worries about milk supply out of your mind.
Be warned … when you first start breastfeeding, it can feel like your baby’s got a mouth full of barbed wire. La Leche League says that 80-90% of breastfeeding moms will experience nipple pain, and 26% will get cracked, extremely sore nipples. Even moms who have breastfed before can be shocked to discover that breastfeeding the second time around is painful at the beginning.
There are many causes of this, and most of them, like poor latching, are simple to fix. With a little time, good nipple care, and the guidance of a lactation consultant, breastfeeding will stop being painful. But don’t wait to ask for help; sore nipples today can very quickly escalate to unbearable levels.
Mastitis is the inflammation of a mammary gland, which presents with flu-like symptoms and a sore area on your breast. While painful, mastitis doesn’t mean the end of breastfeeding. On the contrary, feeding more in order to empty the milk ducts is part of the cure (mastitis doesn’t make the milk unsafe for your baby).
Lactation-safe drugs like paracetamol and ibuprofen will ease the pain, as will ice packs. Consult a doctor if your symptoms persist, since you may need a lactation-safe antibiotic.
Few moms get the hang of breastfeeding instantly. Breastfeeding might be natural, but it doesn’t always come naturally. The majority of new moms need help, support and, most of all, practice. And babies don’t make it any easier. While newborns have a powerful instinct to breastfeed, they too have to get the hang of latching and sucking.
In the first weeks, breastfeeding can be difficult and you might feel like you’re a failure; you’re not! You’re just on the learning curve of breastfeeding – that four-to-six-week period when you’re both trying to master a new skill.
To help you and baby get up to speed quickly, begin breastfeeding within an hour after birth, keep separation from your baby to a minimum, feed your baby on demand, and avoid dummies and bottles.
Returning to work is a very real barrier to breastfeeding. If you have to return to work a few months after your baby is born, find out whether you’ll be able to express at work. If expressing isn’t an option, this doesn’t mean that you shouldn’t consider breastfeeding at all. Any amount of breastfeeding, even if for only a short period, is a gift for your babe.
About the Author: Jude Polack is the founder and director of active birth hospital, Genesis Clinic, where active birth and the support and promotion of breastfeeding are top priorities. For more information on Genesis, visit www.genesisclinic.co.za.
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