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What does a child need to thrive? Most people know that children need shelter, food and love to be happy and healthy, but there's more to consider. Overall child wellbeing can be affected by the child's own personality and those around them like their family and community. But larger systemic trends in a child's home state also have a direct impact on their wellbeing.

The from the 2021 KIDS COUNT® DATA BOOK Annie E. Casey Foundation, an annual study of children across the United States, measures state-specific factors at play in determining overall wellbeing. The data compiled provides great insight into the overall health and wellness of children, explaining a variety of factors that affect children differently depending on where they live. This latest edition includes data about how families have fared as the global Covid-19 pandemic disrupted everyone's lives.

Armed with this information, organizations like KVC can understand the different challenges families and children may be facing. Legislators can make informed decisions about policy. And individuals can also use this data to be informed on ways to donate, volunteer, or get more involved in improving the lives of kids in their community.

Would you like to receive inspiring stories and helpful updates from KVC experts once a month? Subscribe to our newsletter here!

What Contributes to Child Wellbeing?

The KIDS COUNT Data Book looks specifically at four domains to measure overall child wellbeing: economic, education, health and family/community factors. Looking at these four categories provides a closer look at child wellbeing, highlighting bright spots in states as well as areas with room for improvement.

The study looks at four "key indicators" within each category, showing how measurements contribute to the overall picture of how a state is doing.
Here are the 16 key indicators of child wellbeing:
The Impact of Economics, Education, Health, Family Life and Racial Inequity

Economic wellbeing of a state, determined by factors like availability of affordable housing and rate of unemployment, contributes to how well parents are able to support their children. According to the data, "growing up in poverty is one of the greatest threats to healthy child development." When a child grows up in poverty, they have an increased risk of experiencing negative impacts to their brain development, negative health outcomes and poor performance in school. Some of the most life-altering impacts of growing up in poverty are the increased likelihood of teen pregnancy and failure to graduate from high school, both of which have lasting economic consequences.

Having both access to and a high quality of education plays a large role in determining outcomes for kids. With a strong foundation during the elementary years, kids are more prepared for, and more likely to make, post-secondary plans, including which college they might attend and what jobs they might get as adults. Early in a child's life is a critical time to set a foundation for successful learning. A good education leads to finishing high school and achieving a college degree. Both of these correlate with higher income and success levels. It also allows kids to "successfully transition to adulthood," as stated in the 2021 KIDS COUNT Data Book.

Healthcare is similar to education in that it is important that kids have both access and quality. Healthcare is a fundamental part of overall child wellbeing and development. It includes not just doctor or dentist visits, but attention to nutrition and their psychological health as well. The KIDS COUNT Data Book mentions, "exposure to violence, family stress, inadequate housing, lack of preventive health care, poor nutrition, poverty and substance abuse" as direct factors in undermining a child's health. When a child has good health, they are likely to have better outcomes in school and beyond.

Families and communities also impact children in a vital way. This category is close to our heart at KVC, given the work we do to strengthen families and build relationships with kids to help them thrive. We know that children develop the best in loving families, with supportive and trusting relationships to help them learn and grow. When children suffer abuse or maltreatment within their families, they are more likely to experience mood disorders, do poorly in school, and even commit suicide. Children's wellbeing is greatly improved when they have parents committed to their success, and when they live in communities with strong institutions, good schools and effective support services.

Racial inequities continue to be a factor present in all states and across all domains. According to the study, "the nation's racial inequities remain deep, systemic and stubbornly persistent. Data suggest that we as a nation fail to provide children of color with the opportunities and support they need to thrive."

How Does Your State Rank?

The 2021 Data Book shows improvement nationally on 11 of 16 indicators over the last decade. The top ten states for overall child wellbeing are Massachusetts, New Hampshire, Minnesota, Vermont, Utah, New Jersey, Nebraska, Connecticut, Iowa and Wisconsin. Regionally, the Northeast has the most states with high rankings in wellbeing. Appalachian and Southern states have the lowest ranking. The bottom 17 states (besides Alaska) in the rankings can be found in these regions.
View the full list of state rankings here.
How is KVC Working to Improve Children's Overall Wellbeing?

KVC Health Systems has a long history of strengthening families, developing parenting skills, and equipping families to prevent the need for foster care. Often, it is factors like poor economic resources or lack of access to healthcare that leads families to struggle. But we know that any type of disruption can greatly impact a child. One of our services across our entire network is in-home family support , which aims to ensure that families have the skills needed to safely care for their children, help parents find jobs where they can earn a suitable wage, and work with them to access healthcare.

If foster care is needed so that families can overcome obstacles like substance use, incarceration, abuse or neglect, we work to ensure that children are safe and can securely reunite with their families in as short a time as safely possible. We work with foster families, training and guiding them to provide the best possible home for children who have come to live with them.

With the passing of the Family First Prevention Services Act that became law in 2018, federal funding was made available aimed at keeping children with their families and supporting programs that prevent the need for foster care. KVC supports policies that impact families and children's overall wellbeing so that they can be happy, healthy and safely together. Learn more about how we're working to help children and teens in Kansas, West Virginia, Kentucky, Missouri and Nebraska here.
Related articles:

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4 State-Specific Factors That Affect a Child's Wellbeing - KVC Health Systems

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What does a child need to thrive? Most people know that children need shelter, food and love to be happy and healthy, but there's more to consider. Overall child wellbeing can be affected by the child's own personality and those around them like their family and community.

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Center on the Developing Child at Harvard University

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How is ongoing, severe stress and adversity in early childhood connected to chronic disease in adults? And, what can we do about it? In this animated video, narrated by Center on the Developing Child Director Jack P. Shonkoff, M.D., learn what the latest science tells us about how early experiences affect not only early learning and school readiness, but also lifelong health. Understand the effects of adversities such as poverty, discrimination, systemic racism, exposure to violence, and child maltreatment, abuse, and neglect on the developing brain and many other systems in the body. Challenge yourself to think about how we can use policies and resources to address the sources of these problems. And, consider how integrating pediatric primary care with every aspect of the early childhood ecosystem may be an important part of the solution.

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How Early Childhood Experiences Affect Lifelong Health and Learning - Center on the Developing Child at Harvard University

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How is ongoing, severe stress and adversity in early childhood connected to chronic disease in adults? And, what can we do about it? In this animated video, narrated by Center on the Developing Child Director Jack P. Shonkoff, M.D., learn what the latest science tells us about how early experiences affect not only early learning [...]

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Centers for Disease Control and Prevention

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Recommendations for Ages 18 Years or Younger, United States, 2023

To make vaccination recommendations, healthcare providers should:

1. Determine needed vaccines based on age (Table 1)

2. Determine appropriate intervals for catch-up, if needed (Table 2)

3. Assess for medical conditions and other indications (Table 3)

4. Review special situations (Vaccination Notes)

5. Review contraindications and precautions to vaccination (Appendix)

Administer recommended vaccines if immunization history is incomplete or unknown. Do not restart or add doses to vaccine series for extended intervals between doses. When a vaccine is not administered at the recommended age, administer at a subsequent visit. The use of trade names is for identification purposes only and does not imply endorsement by the ACIP or CDC.

Notes

For vaccination recommendations for persons ages 19 years or older, see the Recommended Adult Immunization Schedule, 2023.

Additional information

Consult relevant ACIP statements for detailed recommendations.

For calculating intervals between doses, 4 weeks = 28 days. Intervals of ≥4 months are determined by calendar months.

Within a number range (e.g., 12-18), a dash (-) should be read as "through."

Vaccine doses administered ≤4 days before the minimum age or interval are considered valid. Doses of any vaccine administered ≥5 days earlier than the minimum age or minimum interval should not be counted as valid and should be repeated as age-appropriate. The repeat dose should be spaced after the invalid dose by the recommended minimum interval. For further details, see Table 3-2, Recommended and minimum ages and intervals between vaccine doses, in General Best Practice Guidelines for Immunization.

Information on travel vaccination requirements and recommendations is available at https://www.cdc.gov/travel/.

For vaccination of persons with immunodeficiencies, see Table 8-1, Vaccination of persons with primary and secondary immunodeficiencies, in General Best Practice Guidelines for Immunization, Immunization in Special Clinical Circumstances (In: Kimberlin DW, Barnett ED, Lynfield Ruth, Sawyer MH, eds. Red Book: 2021-2024 Report of the Committee on Infectious Diseases. 32nd ed. Itasca, IL: American Academy of Pediatrics; 2021:72-86).

For information about vaccination in the setting of a vaccine-preventable disease outbreak, contact your state or local health department.

The National Vaccine Injury Compensation Program (VICP) is a no-fault alternative to the traditional legal system for resolving vaccine injury claims. All vaccines included in the child and adolescent vaccine schedule are covered by VICP except for dengue, PPSV23 and COVID-19 vaccines. COVID-19 vaccines that are authorized or approved by the FDA are covered by the Countermeasures Injury Compensation Program (CICP). For more information, see www.hrsa.gov/vaccinecompensation or www.hrsa.gov/cicp.

Haemophilus influenzae type b vaccination
(minimum age: 6 weeks)

Meningococcal serogroup A, C, W, Y vaccination (minimum age: 2 months [MenACWY-CRM, Menveo], 9 months [MenACWY-D, Menactra], 2 years [MenACWY-TT, MenQuadfi])

Meningococcal serogroup B vaccination
(minimum age: 10 years [MenB-4C, Bexsero®; MenB-FHbp, Trumenba®])

Appendix - Guide to Contraindications and Precautions to Commonly Used Vaccines

Adapted from Table 4-1 in Advisory Committee on Immunization Practices (ACIP) General Best Practice Guidelines for Immunization: Contraindication and Precautions and ACIP's Recommendations for the Prevention and Control of 2022-23 seasonal influenza with Vaccines.

Influenza, cell culture-based inactivated injectable
[(ccIIV4), Flucelvax ® Quadrivalent]

Influenza, cell culture-based inactivated injectable
[(ccIIV4), Flucelvax ® Quadrivalent]

Influenza, live attenuated [LAIV4, Flumist ® Quadrivalent]

Influenza, live attenuated [LAIV4, Flumist ® Quadrivalent]

Severe allergic reaction (e.g., anaphylaxis) after previous dose of any influenza vaccine (i.e., any egg-based IIV, ccIIV, RIV, or LAIV of any valency)

Severe allergic reaction (e.g., anaphylaxis) to any vaccine component³ (excluding egg)

Children age 2 - 4 years with a history of asthma or wheezing

Anatomic or functional asplenia

Immunocompromised due to any cause including medications and HIV infection

Close contacts or caregivers of severely immunosuppressed persons who require a protected environment

Pregnancy

Cochlear implant

Active communication between the cerebrospinal fluid (CSF) and the oropharynx, nasopharynx, nose, ear or any other cranial CSF leak

Children and adolescents receiving aspirin or salicylate-containing medications

Received influenza antiviral medications oseltamivir or zanamivir within the previous 48 hours, peramivir within the previous 5 days, or baloxavir within the previous 17 days

Contraindicated or Not Recommended ¹

Severe allergic reaction (e.g., anaphylaxis) after previous dose of any influenza vaccine (i.e., any egg-based IIV, ccIIV, RIV, or LAIV of any valency)

Severe allergic reaction (e.g., anaphylaxis) to any vaccine component³ (excluding egg)

Children age 2 - 4 years with a history of asthma or wheezing

Anatomic or functional asplenia

Immunocompromised due to any cause including medications and HIV infection

Close contacts or caregivers of severely immunosuppressed persons who require a protected environment

Pregnancy

Cochlear implant

Active communication between the cerebrospinal fluid (CSF) and the oropharynx, nasopharynx, nose, ear or any other cranial CSF leak

Children and adolescents receiving aspirin or salicylate-containing medications

Received influenza antiviral medications oseltamivir or zanamivir within the previous 48 hours, peramivir within the previous 5 days, or baloxavir within the previous 17 days

Measles, mumps, rubella (MMR)
Measles, mumps, rubella, and varicella (MMRV)

Measles, mumps, rubella (MMR)
Measles, mumps, rubella, and varicella (MMRV)

Meningococcal ACWY (MenACWY)
[MenACWY-CRM (Menveo ®); MenACWY-D (Menactra ®); MenACWY-TT (MenQuadfi ®)]

Meningococcal ACWY (MenACWY)
[MenACWY-CRM (Menveo ®); MenACWY-D (Menactra ®); MenACWY-TT (MenQuadfi ®)]

Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³

For MenACWY-D and Men ACWY-CRM only: severe allergic reaction to any diphtheria toxoid- or CRM₁₉₇-containing vaccine

For MenACWY-TT only: severe allergic reaction to a tetanus toxoid-containing vaccine

Contraindicated or Not Recommended ¹

Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component³

For MenACWY-D and Men ACWY-CRM only: severe allergic reaction to any diphtheria toxoid- or CRM₁₉₇-containing vaccine

For MenACWY-TT only: severe allergic reaction to a tetanus toxoid-containing vaccine

Tetanus, diphtheria, and acellular pertussis (Tdap)

Tetanus, diphtheria (Td)

Tetanus, diphtheria, and acellular pertussis (Tdap)

Tetanus, diphtheria (Td)

1. When a contraindication is present, a vaccine should NOT be administered. Kroger A, Bahta L, Hunter P. ACIP General Best Practice Guidelines for Immunization.

2. When a precaution is present, vaccination should generally be deferred but might be indicated if the benefit of protection from the vaccine outweighs the risk for an adverse reaction. Kroger A, Bahta L, Hunter P. ACIP General Best Practice Guidelines for Immunization.

3. Vaccination providers should check FDA-approved prescribing information for the most complete and updated information, including contraindications, warnings, and precautions. See Package inserts for U.S.-licensed vaccines.

4. For information on the pregnancy exposure registries for persons who were inadvertently vaccinated with Heplisav-B or PreHevbrio while pregnant, please visit heplisavbpregnancyregistry.com/ or www.prehevbrio.com/#safety.

Vaccines in the Child and Adolescent Immunization Schedule*

Combination Vaccines

(Use combination vaccines instead of separate injections when appropriate)

DTaP, inactivated poliovirus, and Haemophilus influenzae type B vaccine

DTaP-IPV/Hib

DTaP, inactivated poliovirus, Haemophilus influenzae type b, and hepatitis B vaccine

DTaP-IPV-Hib-HepB

* Administer recommended vaccines if immunization history is incomplete or unknown. Do not restart or add doses to vaccine series for extended intervals between doses. When a vaccine is not administered at the recommended age, administer at a subsequent visit. The use of trade names is for identification purposes only and does not imply endorsement by the ACIP or CDC.

This schedule is recommended by the Advisory Committee on Immunization Practices ( ACIP) and approved by the Centers for Disease Control and Prevention ( CDC), American Academy of Pediatrics ( AAP), American Academy of Family Physicians ( AAFP), American College of Obstetricians and Gynecologists ( ACOG), American College of Nurse-Midwives ( ACNM), American Academy of Physician Associates ( AAPA), and National Association of Pediatric Nurse Practitioners ( NAPNAP).

The comprehensive summary of the ACIP recommended changes made to the child and adolescent immunization schedule can be found in the February 10, 2023 MMWR.

Report

Suspected cases of reportable vaccine-preventable diseases or outbreaks to your state or local health department

Clinically significant adverse events to the Vaccine Adverse Event Reporting System (VAERS) at www.vaers.hhs.govexternal icon or (800-822-7967)

Questions or comments
Contact www.cdc.gov/cdc-info or 800-CDC-INFO (800-232-4636), in English or Spanish, 8 a.m.-8 p.m. ET, Monday through Friday, excluding holidays.
Helpful information

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View and Print CDC immunization schedules for those ages birth through 18 years.

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Breastfeeding Info A to Z

This information is on topics of interest to parents of breastfed children. It is general in nature and may not be pertinent to your family's lifestyle. It is not intended to be advise, medical or otherwise. If you have a serious breastfeeding problem or concern, please talk directly to a La Leche League Leader which will provide you with support, encouragement, and evidence-based information. LLLI does not engage in the practice of medicine; please consult a health care professional on any medical issue.

Food Allergies and Breastfeeding

Babies are more likely to develop allergies if there's a history of eczema, asthma, hay fever or food allergies in the family. If your baby has a family history of these conditions, breastfeeding your baby exclusively for the first six months will help to lower their risk.

Substances in human milk coat your baby's intestines, which prevents microscopic food particles from "leaking" through into your baby's bloodstream. If they do pass into the blood (something that is more frequent in an artificially fed baby), these food particles may be treated as foreign substances by his white blood cells, which attack them, and can cause painful allergic reactions such as diarrhea, sore bottoms, runny noses and eyes, rashes and eczema, or a crying, sleepless baby.
Full Allergies Article

Why Carry Your Baby in a Carrier or Sling?

Carrying your baby in a carrier or sling is a lovely way to meet needs for warmth and closeness, and is not just for mothers. All parents can nurture their babies in this way; your baby's carer may also find it an invaluable tool while you are working or studying.

Babies carried in slings are calmer and cry less. In most cultures, where babies are held almost constantly, they are typically in a quiet alert state and rarely cry for more than brief periods.

Slings provide a gentle way of transitioning babies from the calm environment of the womb to that of the outside world. Babies in carriers continue to be rocked by their mothers' movements and to hear their mothers' heartbeats or learn a new caring adult's rhythms. This helps babies to regulate their own systems.

Full Baby Wearing Article

BIRTH CONTROL

Non-hormonal methods of contraception are compatible with breastfeeding though no method is 100% effective against pregnancy regardless of whether you are breastfeeding or not. Examples include:

Barrier methods (condom, diaphragm, cervical cap, sponge )

Non-hormonal IUD (coil)

Spermicides

LAM (Lactational Amenorrhea Method)

Natural Family Planning

Some hormonal methods of contraception may affect milk supply especially in the early months after birth. Examples include:

Contraceptive pill, including combination and progesterone only

Contraceptive implants, injections and patches

Hormonal IUD (coil)

Vaginal ring

Full Birth Control Article

FEEDING BREASTMILK FROM A BOTTLE

When the nursing parent is away from baby or cannot nurse at the breast or chest, it is important that the baby will take breastmilk by another method. These tips assume that the baby is being fed expressed breastmilk. If this is not available, ask the baby's health care provider for advice.

The Womanly Art of Breastfeeding, the La Leche Leage guide for nursing parents, suggests that the introduction of a bottle wait until the baby is three to four weeks old and nursing well, in order to lessen the risk of nipple confusion. You may want to try once or twice per day to introduce the bottle, using a couple of "tricks" that experienced working/breastfeeding mothers have tried.

Full Bottles Article
Introducing a Bottle to a Breastfed Baby

Will I ever have sex after baby?

I am so tired, all I can think about is sleep.

I have been holding the baby all day; I am touched out.

I am in awe of my body, and I feel empowered.

Many parents report changes in their sexual lives while breastfeeding. Physical changes in our bodies during the post-partum period and lactation, lack of sleep, and the demands of caring for young children all contribute to a shifting sense of self, including our experiences of ourselves as sexual beings. Whatever you are experiencing, from increased desire, to no desire at all, and everything in between, others have been there before you. Discussing your experiences with others, such as at a La Leche League meeting, can be a reassuring way to feel that you are not alone.
Full Breastfeeding and Sex Article

Will caffeine affect my baby?

You might be wondering if your morning cup of coffee or tea may have an effect on your baby. The news is good: breastfed babies generally do not suffer ill effects from mother's moderate caffeine consumption. However, you may want to take the following into consideration:

Is my baby more likely than others to react to caffeine?

Babies who are under six months or have other health issues may be more likely to show symptoms (Hale 2017).

What symptoms might my baby have?

A baby who is showing signs of caffeine intake may be unusually irritable, fussy, or wakeful. They may have a harder time staying asleep (Mohrbacher 2010).
Full Caffeine Article

Usually when it is recommended that a breastfeeding mother eliminate dairy produce from her diet, it is because of a problem that may be caused by the protein it contains, not because of lactose intolerance. Human milk is full of lactose, and nature has made certain that babies and toddlers can digest it. Large protein molecules from cow's milk can pass into human milk fairly intact and it is these particles that can bother a sensitive baby. If your baby has Cow's milk protein intolerance (CMPI) he might have colic-like symptoms, and be wheezy, vomit, have diarrhea (including bloody diarrhea), constipation, a rash, eczema and/or a blocked nose.

If you suspect your baby is sensitive to the cow's milk protein in your diet you can remove dairy products and see if it makes a difference. It can take up to 21 days for all traces of cow's milk protein to leave your system so it's best to wait for two to three weeks to evaluate the results. Some babies will react well if you remove visible dairy products such as milk, yoghurt, cheese, cream and ice-cream; others will not show any improvement unless you remove every trace of cow's milk protein from your diet so you may need to read the labels of all the food you eat and eliminate hidden sources.
Full CMPI - Cow's Milk Protein Intolerance Article

Human milk comes in a variety of colors. If you pump your milk you may see lots of variation in color: whereas formula milk always looks the same, the composition and appearance of human milk changes throughout the day, and even throughout a pumping session or feed.

Breastmilk may be white, yellow, clear or have a blue tint to it. Ingredients in many foods and beverages that you might ingest can also tinge your milk in a variety of ways. The following are possible variations:

Diets high in pureed or mashed yellow-orange vegetables (yams, squash, carrots etc) lead to high levels of carotene in milk, which can turn it yellow or orange. Carotene is completely harmless to babies - read our post on *link* carotenemia.

Food dyes used in carbonated sodas, fruit drinks, and gelatin desserts have been associated with milk that is pink or pinkish orange.

Greenish milk has been linked to consuming green- colored sports beverages, seaweed, herbs, or large amounts of green vegetables (such as spinach).

Full Color of Milk Article

Breastfeeding is the most natural and normal way of feeding and nurturing your baby, and is highly valued in many cultures. Many mothers also find that although they feel proud of nursing their baby, they feel concerned about how to do this in a public place without drawing unwanted attention to themselves.

Being modest doesn't have to keep you and your baby at home (or hidden in the restrooms). It's easy to breastfeed discreetly in public if you wear the right clothes. A loose-fitting shirt or top that lifts or can be unbuttoned from the waist will let you feed your baby without exposing your breast, because the baby will cover the nipple and lower breast. You can also buy special nursing blouses, dresses, or shirts, with hidden slits and panels, or modify your existing clothes. If you wear a nursing bra, it's easiest to breastfeed discreetly if the bra can be pulled up or unfastened and re-fastened with one hand. Layering of clothes can often be helpful so that you can use the "one up, one down" method and lift your outer layer up and pull down a vest underneath. This is good for warmth too.
Full Discretion Article

Brand new baby? Tight, full breast? Baby having trouble latching on? You probably have "first week engorgement." And there may be some simple solutions.
Mothers have come to see engorgement as the natural follow-up to birth. But it's more often a natural follow-up to modern expectations of age-old biology. In a nutshell, babies and breasts expect a lot more cuddling and nursing than many new mothers expect.

You've been making milk since your first trimester. Maybe you leaked, maybe you didn't. But that first milk - colostrum - was there. Colostrum is thick and yellowish and sluggish and more salty than sweet, but it's full of antibodies and protein. Call it "practice milk" for your newborn. It coats your baby's stomach and intestines with antibodies. It fuels but it doesn't flood.

Now wait a couple days. Your hormones shift. The blood supply to your breasts increases to start up the milk factory, causing fullness. (If you've had IV fluids, that fullness may be more than normal.) Sugar enters your early milk, which pulls water into it. It turns white. From now on, your milk will be sweet and sloshy, and there will be a lot more of it... provided your body gets the message it's looking for.
Full Engorgement Article

Whether you are used to running marathons or want to start some gentle activities to help with your fitness and/ or weight loss goals you might be wondering if your milk supply will be affected by exercise.

It's worth remembering that women with babies have always worked - the bottom line is that throughout history and in many cultures they couldn't afford not to. Often this work involved fairly strenuous manual labor and we know these moms continued to breastfeed their babies without problems.

Most people feel better when they get some exercise, and this is certainly good for both mother and baby.
Full Exercise Article

Breastfeeding can have an effect on your fertility, particularly in the early months. While for some mothers this is a benefit, it can also be a source of frustration for those hoping to grow their families.

CAN I GET PREGNANT WHILE I'M NURSING?

The simple answer is that you can get pregnant while nursing.

However, many moms experience a time of delayed fertility during breastfeeding. This is very common and is referred to in many places as the Lactation Amenorrhea Method of contraception.

As described in THE WOMANLY ART OF BREASTFEEDING, the Lactation Amenorrhea Method of using breastfeeding to delay fertility needs all the following to be true:

1. Your periods have not returned.

2. Your baby is exclusively and frequently fed from your breasts- this is especially important to remember when your little one begins sleeping through the night. It means not just that your baby does not have bottles, but also that they do not use a pacifier, in other words that all of your baby's sucking needs are met at your breast.

3. Your baby is less than 6 months old. If your little one is older and eating solid foods, your chances of ovulating and risk of pregnancy increases. Some moms will find it takes more than six months for their cycles and fertility to return, while other mothers find that their cycles and fertility return earlier than six months. It is also important to mention that after six months, there is a higher chance that you might ovulate and possibly become pregnant before your first postpartum period. If you suspect you are pregnant, you will want to check with your health care professional.

Full Fertility Article

Are there any foods I should avoid while breastfeeding?

One of the concepts La Leche League is founded on is "Good nutrition means eating a well-balanced and varied diet of foods in as close to their natural state as possible."

You don't need to eat anything special while you're breastfeeding. But it's a good idea for you, just like everyone else, to eat a varied and healthy diet. The food any family chooses will depend on personal preference, climate, culture and finances.
There are no foods you need to avoid while breastfeeding (unless you're allergic to them of course!).Some strongly flavored foods may change the taste of your milk, and many babies seem to enjoy a variety of breast milk flavors! Often the dominant flavors of your diet - whether soy sauce, chili, garlic or something else - were in your amniotic fluid during pregnancy. Before birth babies swallow amniotic fluid and are accustomed to these flavors before tasting them in your milk.
Full Foods Article

This information is for birth parents with babies born at full term or close to full term and addresses the normal course of breastfeeding.

How often should I feed my baby in the first 24 hours after birth?

How often should I breastfeed my baby in the first few days?

How does nursing frequently prevent my baby from becoming jaundiced or help if he/she does become jaundiced?

How can I tell whether my baby is getting enough milk from me?

Should I put my baby on a schedule?

How will I know when my baby is hungry if I don't use a schedule?

How often should I breastfeed my baby in the first weeks?

How often should I breastfeed my baby in the first six months?

Do I need to breastfeed my baby at night?

I'm not sure I'm making enough milk-my baby is fussy! How can I increase my milk supply?

People say I'm spoiling my baby by nursing her/him too often. How often is right?

Why does my baby suddenly want to breastfeed constantly?

Full Frequency of Feeding FAQs

When your baby is spitting up many times a day and seems very unhappy with feedings, he may have gastroesophageal reflux disease. Although baby will need assessed by his doctor, symptoms include:

Frequent spitting up, often with pain

More uncomfortable when sitting than when upright on chest

Gagging, choking, coughing, burping or frequent hiccuping

Bad breath

Uncomfortable when laid down, sleeps poorly

Full GERD - Gastroesophageal Reflux Disease Article

Hand expression is a useful technique, and what's more it's convenient and free! It's a handy way to relieve engorged breasts. You can use it to stimulate milk production if you need to increase your supply, and to provide milk for your baby. You can also combine hand expressing with pumping - read more about pumping here: LINK

Hand expression is often used for antenatal expression of colostrum - read more here.

Hand expression is simple to learn and gets easier with practice. Follow these steps:

Wash your hands.

You can use any clean container you like to collect your milk, colostrum can be expressed into a small (5ml) container or even onto a teaspoon if you want to feed it to your baby immediately.

Relax and get comfortable: your milk will flow more easily if you are warm and comfortable.

Privacy can help: try the breathing exercises you learnt for use during labour; visualise flowing milk.

It can be easier to get your milk flowing if your baby is nearby - if he is not try thinking about him, or looking at a photo or recording of him.

Many moms find that keeping a piece of clothing that smells of their baby close-by helps - this may be especially helpful if you're separated from your baby, for example if your baby is in special care (NICU).

Take some deep breaths and drop your shoulders.

Gently massage your breasts with your hands and fingertips to stimulate your milk ejection reflex (MER or 'let-down') - this is the key to effective expressing.

Bending forward with your breasts suspended means gravity can help milk flow.

Full Hand Expressing Article

How long should I breastfeed?

You can breastfeed for as long as you and your baby want to.

One of the concepts La Leche League is founded on is that "Ideally the breastfeeding relationship will continue until the baby outgrows the need."

The World Health Organization and UNICEF recommend that babies be breastfed for at least two years.

"Review of evidence has shown that, on a population basis, exclusive breastfeeding for six months is the optimal way of feeding infants. Thereafter infants should receive complementary foods with continued breastfeeding up two years of age or beyond." 1

As solids are introduced, usually around the middle of the first year, your baby will begin to shift his primary source of nutrition from your milk to other foods.
Full Length of Time Article

LUMP IN BREAST

Finding a lump in your breast is scary! Fortunately, most lumps in a lactating mother's breasts are either milk-filled glands or an inflammation, such as a blocked duct or mastitis. If the lump is tender, it is probably mastitis. Check out this page for information on treating mastitis.

If the lump does not go away after a week of careful treatment for a blocked duct/ mastitis or if you are experiencing sudden flu-like symptoms or a high fever, or are at all concerned, contact your healthcare provider. If you notice red streaks on your breasts seek medical attention as they are a sign of infection that, left untreated, can develop into sepsis, a life threatening complication of an infection.
Full Lumps and Mammograms Article

Having a sore breast can be a painful and alarming experience and can occur when the milk flow in your breast is blocked. Your breast may feel tender, there may or may not be redness or a hard spot or sore lump in your breast. Treat any engorgement promptly to avoid developing blocked ducts or mastitis.

Whether you have a sore breast, a plugged duct or a breast infection, the initial care is similar: nurse frequently, rest and apply heat to the tender area.

BLOCKED DUCTS

Milk flows through a duct system in your breasts. Sometimes an area of the ducts becomes blocked and milk stops flowing well. A section of your breast may or may not be red. If you have a plugged duct, your breast will usually be tender though the pain will be localised. If the blockage is not treated, the area may become infected.
Full Mastitis Article

One of the most common questions that mothers ask their health care providers is- "Can I safely take medication while breastfeeding?" Sometimes mothers are told that they cannot continue breastfeeding while taking a certain medication. Some are told to wean, or to "pump and dump" for a certain number of days.

According to Dr. Thomas Hale, author of Medications and Mother's Milk 2017, "most drugs do not enter milk in levels that are hazardous to a breastfed infant." However, it is important to check reliable sources for up-to-date research-based information.

Many health care providers rely on the package insert of the medication that they are prescribing. The package insert almost always cautions against prescribing the medication to pregnant or lactating mothers. However, there are many reliable resources for finding more accurate answers.
Full Medications Article

Whether you are someone who produces more milk than your baby needs, or you're someone who is unable to produce as much as you'd like for your baby or cannot nurse your baby for other reasons, you may have considered milk donation or milk sharing. Either way, you should be aware of some potential risks. Research has shown that the "perceived risks and benefits of feeding milk from another mother may not align with actual risks and benefits"[i][ii]. However, milk sharing and donation are perceived differently in different cultures around the world; what one country and culture sees as potentially risky may be a long-standing and widely accepted tradition in another country and culture. Hence, we are not here to make any judgment about these practices. Instead, we simply hope to offer information that will allow you to make an informed decision that is right for you, your baby, your family, and your location.

As per our milk donation policy, La Leche League International cannot facilitate milk sharing. You may be wondering why. You can read our policy at the end of this post.

Skip to LLLI Milk Donation policy
Skip to FAQ Donor Information & Questions
Full Milk Donation and Sharing Article

Is it OK to mix human milk and artificial baby milk (formula)?

Mixing refers to giving your baby your own milk and artificial baby milk in the same container. This is actually a form of supplementation. Supplementation means giving your baby liquid nourishment in addition to breastfeeding. Giving your milk and any supplement separately is advantageous for these two reasons:

Your baby will receive the immunological benefits of human milk and

Less will have the chance to be wasted than if the milks were mixed.

Reasons supplementation of a breastfed baby may be necessary include if the nursing parent's supply is low or if the baby is separated from the parent. However, there are many options in these cases, including the possibility of supplementing with breast milk, donor human milk or formula, so be sure to contact your La Leche League Leader to discuss your particular circumstances.
Full Mixing Milk Article

The term nipple confusion or nipple preference has been used to describe an infant's fussiness at breast or frustration when they are having problems switching from a bottle nipple and breast, before breastfeeding is well established. A baby uses a totally different technique to remove milk from the breast than he uses to drink from a bottle. Some babies have difficulty alternating between a bottle and the breast and some do not. There is no way to predict who will have problems breastfeeding after drinking from a bottle. Babies that are born early or babies with a weaker or more uncoordinated suck may be more vulnerable to nipple confusion. Breastfeeding experts disagree to what extent baby's have difficulty with nipple preference or confusion.

Ways To Avoid Nipple Confusion:

1. Wait until breastfeeding is well established and feels like part of your daily routine. Many mothers recommend postponing a bottle at least 4 weeks.

2. If baby needs to be supplemented then consider other alternatives like a feeding cup or a supplemental nursing system.

3. Inform hospital staff of your wish to not give a pacifier or supplement to baby unless medically indicated.

Full Nipple Confusion Article

Sometimes a mother may make more milk than her baby needs. Although this may sound like a good problem to have, too much of any good thing can cause challenges - for baby and mother.

WHAT ARE SOME SIGNS OF OVERSUPPLY?

Baby is restless during the feeding, may cry or pull off and on the breast.

Baby may cough, choke, splutter, or gulp quickly at the breast, especially with each let-down. See Positioning

Baby may clamp down at the nipple to try to stop or slow the rapid flow of milk. This may cause sore, creased nipples. See Biting

Baby may arch or stiffen, often with painful cries.

Each feeding feels like a struggle or battle.

Feedings may be short but frequent because baby fills up quickly on air and the lower fat milk from the early part of a feeding and not get to the higher fat that comes further into the feeding.

Baby may have green, loose, or explosive stools. Some may have signs of blood.(See section on digestion concerns, below)

Baby may be very gassy and have frequent, large spit ups. See Breastfeeding and Reflux and Breastfeeding and GERD .

Mother may notice a strong, forceful milk release, also know as Overactive Milk Ejection Reflex (OMER). This can cause coughing or choking. This may also result in excessive leaking from the side where baby is not feeding.

Mother's breasts may never feel fully empty and seem to refill very quickly after a feeding.

Mother may have frequent bouts of plugged ducts or mastitis.
NOTE: Some mothers may benefit from having their thyroid levels checked as overactive thyroids can contribute to oversupply.

Full Oversupply Article

Note: For clarity, we are referring to baby as "he" and mother as "she."
THE FIRST WEEK: POSITIONING AND LATCH

Breastfeeding is a gift only you can give your baby. A healthy, full term baby is likely to know instinctively what to do at the breast.

During the early weeks skin-to-skin contact helps your baby be connected to his instinctive breastfeeding skills and helps you and baby enjoy breastfeeding. Each mother discovers what works for her, and what works for one mother may not work for another. Mary Renfrew wrote in Journal of Human Lactation that learning to breastfeed is like mother and baby learning a dance. Use what works in these suggestions and tailor them for you and your baby. Trust that you know what works for you and your baby. You will know when the positioning is ideal for you, when you and your baby are comfortable. When positioning is right for you, your nipples stay healthy and your baby can feed most efficiently. Concern about sore nipples or breastfeeding comfortably is a common reason that mothers contact La Leche League. Improving positioning helps eliminate many cases of sore nipples.

You may have noticed this description is long. Be assured that many mothers have successfully accomplished breastfeeding their babies for centuries and you too will learn how to best position your baby. These suggestions are not meant to tell the mother that if she follows all the steps the position will be "right". The suggestions are meant to gives you ideas on how you and your baby can learn to breastfeed and enjoy the breastfeeding experience.
Full Positioning Article

Many women experience a roller coaster of emotions after having a baby, from joy and elation to worry and sadness. Mix big feelings with limited sleep and meeting the needs of a new baby, and new parenthood can feel overwhelming at times.

Having a baby is a life-changing experience, and around 85% of women experience some kind of mood disturbance postpartum.[1] Despite being so common, postpartum (postnatal) mood disturbances are not always talked about, leaving some women to feel alone and wondering if they are good enough mothers. Talking openly about your postpartum experiences with others going through the same thing can combat feelings of isolation and shame. Going to a La Leche League meeting is a great place to find other new mothers to share experiences with.
Full Postpartum Mood Disorder Article

There are times when mothers are separated from their child for work or for school. It is important to know that you can still provide milk for your child when you are away and you can maintain your breastfeeding relationship.

HOW OFTEN WILL I HAVE TO PUMP WHEN I GO BACK TO WORK OR SCHOOL (COLLEGE)?

How long you are apart from you baby influences this decision. Ideally, you would pump as often as your baby would nurse. This may not be possible with your work/ school schedule. Most mothers find that pumping every 2-3 hours maintains their milk supply and does not cause them to become uncomfortably full.

For example, if a mother worked an 8 hour work day, she would nurse her child before coming to work, then pump mid-morning, at lunchtime and then mid-afternoon. She would nurse her baby when she returned home.
Full Pumping Milk Article

When you are pumping milk for your baby, it is important to clean your pumping accessories properly, whether at work or at home.

ITEMS TO BRING WITH YOU IN ADDITION TO YOUR PUMP KIT

Mild, unscented dish soap (washing up liquid).

Bottle brush.

Wash basin (many hospitals provide these to their patients); two if you can - one for washing and the other for drying.

Full Cleaning and Sanitizing Pumping Accessories Article

A baby spitting up occasionally is usually looked at as "something babies do." According to the late Dr. Gregory White, husband of the late LLLI Founder, Mary White, "In a healthy baby, spitting up is a laundry problem, not a medical problem."

A baby may spit up for lots of reasons:

Baby is not be able to swallow quickly enough when milk ejects forcefully during a feeding, resulting in swallowing excess air.

Mother has an oversupply of milk that can result in baby taking too much too fast for the stomach to handle. Either can result in additional air swallowed with the large volumes of milk. Read our post on oversupply.

Less common reasons are:

Immature muscle control

Allergy to foods and/or dietary supplements mother may consume

Disease

Full Reflux Article

Skin-to-skin is a biologically normal practice. It consists of placing an unclothed or diaper-only newborn baby chest-to-chest with mother immediately after delivery and keeping them together for at least the first hour after birth, whether the mother has had a vaginal or cesarean birth and regardless of feeding method planned. This practice is supported by the World Health Organization (WHO), Baby Friendly Hospital Initiative (BFHI), the Academy of Breastfeeding Medicine (ABM), and American Academy of Pediatrics (AAP). This is an important component of family-centered care.

Immediate Skin-to-skin care (SSC) for a minimum of one hour after birth is one of the most effective methods for promoting exclusive breastfeeding. Babies who have early SSC are more likely to be exclusively breastfed at discharge, exclusively breastfed after discharge, and breastfed for longer durations.

Reasons why SSC is important for baby and mother:
* Keeps mother and baby together.
* Promotes bonding between mother and baby.
Full Skin-to-Skin Care Article

SLEEP: TALKING WITH YOUR DOCTOR ABOUT BEDSHARING

Some parents choose not to discuss their sleeping arrangements with medical caregivers, even if asked. If you do choose to, here are some points you may find helpful.

I really do appreciate your willingness to listen. It's one of the reason's we came to you.

Although the public health campaigns suggest that all bedsharing with babies is dangerous, the research shows that the issue is complex, and not a one-size fits-all.

Most of the research mixes up SIDS and suffocation. There are ways to make bedsharing safely comparable to a crib's.

Full Sleep: Talking With Your Doctor About Bedsharing Suggestions

According to recommendations from the World Health Organization (WHO), the American Academy of Pediatrics (AAP), and the American Public Health Association (APHA), human milk is the only food that healthy, full-term babies need for about the first six months of life. The composition of human milk changes in response to a variety of cues, so that each mother provides milk that meets her own baby's unique needs. Human milk provides immunity factors for as long as the baby nurses, and many of the health benefits of breastfeeding continue well into childhood and beyond.

Feeding complementary foods to your baby before he is ready is typically messy and inefficient as he will naturally push the food out with his tongue as long as the tongue-reflex is functioning. By waiting for him to be developmentally ready, he becomes an active participant in eating, rather than merely a passive recipient. This helps to put him in charge of how much he eats, teaching him important fullness cues. Starting solid foods before your baby is ready will not increase his sleep at night, is not necessary for larger babies, and does not initially increase calories.
Full Starting Solids Article

It is essential to properly store your expressed (pumped) milk to maximize its nutritional, immunological and antioxidant qualities. Human milk has anti-bacterial properties that help it to stay fresh and when stored per recommendations, human milk can maintain many of its nutritional qualities making it safe for use. Over time nutrients may break down in expressed milk lowering the quality and as such, it is important to try to give your baby the freshest expressed milk to ensure its rich quality.

Prior to expressing and storing milk ALL mothers should:

Wash their hands before expressing;

Use containers that have been washed in hot, soapy water, rinsed and air dried

STORAGE GUIDELINES

This information is based on current research and applies to mothers who have healthy, full-term babies. Babies who are preterm/ in NICU/or ill should use more conservative guidelines.
Full Storing Human Milk Article

TANNING BEDS

No evidence exists that the use of tanning beds has any effect on human milk or breastfed babies. However some mothers have reported getting burnt nipples and breasts when using tanning beds: this is extremely painful so be sure to cover your nipples and breasts and use caution. If you are offered any vitamins or medications to enhance the tanning process you can check them with your health care provider before taking them.

FAKE TAN

You do not need to avoid using tanning lotion, or having a spray tan, when you're breastfeeding. You do however need to take care when applying fake tan (or indeed any cosmetics) when your baby is close, and you need to ensure the fake tan is dry or has been rinsed off before having skin-to-skin contact to avoid accidentally 'tanning' your baby.

The active ingredient in most fake tans is DHA, and some self tanners use erythrulose. Both are non toxic: neither substance can absorb beyond the outermost layer of your skin, and so cannot contaminate your breast milk or harm your baby.
Full Tanning Beds and Fake Tans Article

IS THRUSH CAUSING MY SORE NIPPLES?

Persistent nipple pain in the early weeks of breastfeeding, or nipple pain that appears after several weeks or months of pain-free nursing, may be caused by thrush, which is a yeast infection of the nipples. Thrush is caused by a yeast fungus, usually Candida albicans. Additional symptoms can include:

Itchy or burning nipples that appear pink or red, shiny, flaky, and/or have a rash with tiny blisters

Cracked nipples

Shooting pains in the breast during or after feedings

Intense nipple or breast pain that is not improved with better latch-on and positioning

Deep breast pain

You may be at higher risk for developing thrush if you or your baby has had a recent course of antibiotics, your nipples are cracked or damaged, or you are taking oral contraceptives or steroids (such as for asthma).
Full Thrush Article

Early Start

Put baby to the breast to nurse as soon as possible.

Hold baby skin-to-skin

Avoid pacifiers

Sore Nipples

Correct positioning and latch on are very important for preventing sore nipples.

Break suction before taking baby off the breast.

Offer the least sore breast first.

Use only plain water for washing.

Gently apply your own milk, ultra pure modified lanolin, or hydrogel pads to speed healing.

Check with a La Leche League Leader for help.

Full Tips Article

HOW DO I TRAVEL WITH MY BABY?

Traveling with a baby can be difficult! In many cases, babies travel well. Bringing your baby with you to a special event can be exciting... or nerve-racking!

There are a few things many families have found work when traveling with babies. As always, take what feels right for your family and leave the rest.

FOR A ROAD TRIP:

The car seat - do some research to make sure the car seat you buy for your baby suits your needs. Do you need a car seat that has a base and detachable bucket or would you prefer to have an all-in-one non-detachable seat that will serve as your baby's seat for several developmental stages? Whichever one you choose, look for one you feel confident installing, removing, and moving around. It is also helpful to be very well acquainted with how the car seat buckles and tightens. Many families find it beneficial to practice how to get their babies into and out of their car seats from the front passenger seats and a seat on the side of the car seat. It can be difficult to take your little one out of the car seat and carry them to you in your seat - especially if it is cold or rainy outside. Practice which seat in your vehicle you are able to nurse in the best and learn how to get your baby out of and back into their car seat from your nursing seat safely. Having an additional adult on hand can help boost your confidence - and help ensure baby's safety - while you practice.
Full Travel Article

VACCINES[1]

Many mothers have questions about the compatibility of vaccines and breastfeeding. We encourage families to consult with their healthcare provider for information to help them make an informed decision regarding vaccination. La Leche League does not have a stance on vaccinations, and LLL Leaders cannot offer information about the safety or suitability of choices regarding vaccinations.

This post provides information about vaccines a breastfeeding mother may need, and some ways to comfort a baby who has received a vaccination.

Full Vaccines Article

VITAMINS AND OTHER NUTRITIONAL SUPPLEMENTS FOR BABY

Advertisements, family members and even health professionals often urge mothers to add "something" to baby's perfect diet of mother's milk. According to the our comprehensive guidebook, THE WOMANLY ART OF BREASTFEEDING, if a breastfeeding mother is getting an adequate supply of vitamins in her diet, her milk will contain adequate nutrients in the perfect balance for her baby. If your baby is healthy and doing well, there is no need for vitamins, iron, or other supplements in the early months (apart from vitamin D). Furthermore, many mothers have found that vitamin or fluoride supplements may cause fussiness or colic in their infants. By treating each mother and baby as a unique pair, unnecessary supplementation can often be avoided.
Full Vitamins and Other Nutritional Supplements Article

Exclusively breastfed babies do not need water supplements - your body makes the perfect milk for your baby, actually changing the composition as he needs more or less water.

Giving water to newborn babies can contribute to jaundice and slow weight gain: water may fill a baby's tummy and so reduce the amount of colostrum or breastmilk they get. Water supplements may also stop you establishing your milk supply as your baby will ask to breastfeed less.

Even in very hot weather your baby doesn't need additional water, as long as you respond to his cues to feed he will get all the fluids he needs in your milk. This article from LLL Canada gives more information about breastfeeding and hot weather.
Full Water Supplements Article

WOULD WEANING MAKE MY LIFE EASIER?

Are you thinking about weaning? Your child may be a few weeks or months old, or may be a breastfeeding toddler. Some mothers decide to continue breastfeeding until the baby outgrows the need. This is called natural weaning or child-led weaning. In modern Western society, this is rather unusual. At a typical LLL meeting, you may find many mothers practice extended or natural weaning. You can review the Toddler Nursing article if this seems right to you.

I WANT TO WEAN

Are you still in the early weeks, and experiencing difficulties with breastfeeding?

Maybe you'd like to breastfeed longer, but feel overwhelmed or are experiencing discomfort?

We are here to help, don't hesitate to call your local La Leche League Leader if you are having problems! They can help you with any difficulties you may experience. Sometimes just talking to an experienced parent who has "been there," who understands what you're going through, can be so helpful. All LLL Leaders have breasted at least one baby, for at least one year.
Full Weaning: I Want To Article

Unexpected Weaning

Were you planning on continuing breastfeeding, but your baby has other ideas? Do you worry baby is trying to wean?

First, make sure it isn't just a nursing strike.

Common Reasons for an Early Weaning

Bottles, pacifiers or increased solids. Try cutting down on any of these activities. If your baby is getting bottles at daycare while you are at work, and is over six months old (approximately), it's probably time to go to the cup for the child's feeds while away from you. With dummies, reduce use to your baby won't be meeting his sucking needs, and will be more eager to nurse, when you are together. If you started solids early (before six months), you can always cut back on the size of these meals, gradually, of course. If baby is under 12 months of age, make sure you are offering breast before solids. Your milk supply will build back up, as the baby spends more time at the breast. Remember, your milk is by far the most nutritious food for your baby, for the first year, not to mention the immunological benefits.
Full Weaning: Unexpected Article

HOW CAN I LOSE WEIGHT SAFELY WHILE BREASTFEEDING?

You are not alone in wondering about losing weight. Many women are anxious to return to their pre-pregnancy shape and weight after childbirth. Do try to remember that your pregnancy weight wasn't gained overnight so it won't disappear that quickly, either.

While breastfeeding burns about 500-700 calories extra per day to fuel milk making, this may not always contribute to weight loss postpartum - many factors like pre-pregnancy weight, diet, physical activity level, etc will impact weight loss after birth (Institute of Medicine, 2002; Dewey, 1994). On average, exclusively breastfeeding mothers may see a loss of 1-2 pounds a month and over time, breastfeeding moms tend to lose more weight than mothers who do not breastfeed.

WHEN CAN I START LOSING WEIGHT?

It is recommended that you wait at least 6-8 weeks postpartum to start to lose weight, as your body needs this time to recover from childbirth and establish a good milk supply. Many mothers lose weight in the early months by following a well-balanced diet and eating to hunger.
Full Weight Loss: For Mothers

You may choose to continue breastfeeding while working outside the home for many reasons - the best food for your baby, antibodies to protect your baby, great way to reconnect when you return from work, and continuing the special relationship of breastfeeding during your days at home.

PLANNING AHEAD

Consider all options for returning to work, including taking the longest maternity leave possible if it is available to you.

Can you work at part of the time from home?

It is possible to job share with another employee?

Is it possible to go part-time? Some mothers find that when they factor in the costs of child care, they can reduce their work hours or delay returning to work for a year or more.

Can you come back gradually? Some mothers start back just two or three days a week and gradually work up to a full work week.

Consider flexibility at work.

Can you leave if your baby needs you during the workday?

Can your baby be brought to you?

Full Working and Breastfeeding Article

Going back to work and leaving your baby in someone else's care can be one of the most difficult parts of returning to work. Choosing the right person and right setting takes care. You want to find a setting that will provide the kind of care and attention you would give. You want a setting that respects breastfeeding and your expressed breastmilk. This may take some homework on your part. Visits to the locations you are considering will be important. Here are some things to consider:

IN HOME CARE WITH A FAMILY MEMBER, CLOSE FRIEND, OR NANNY

This allows your baby to stay in your home, where all is familiar.

It works best with someone the baby already knows or who is willing to come to your home several times before your return date.

Full Choosing a Child Care Provider Article

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Breastfeeding Info | La Leche League International

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This information is on topics of interest to parents of breastfed children. It is general in nature and may not be pertinent to your family's lifestyle. It is not intended to be advise, medical or otherwise. If you have a serious breastfeeding problem or concern, please talk directly to a La Leche League Leader which will provide you with support, encouragement, and evidence-based information.

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Centers for Disease Control and Prevention

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CDC's Infant and Toddler Nutrition website

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Visit CDC's Infant and Toddler Nutrition website to learn about benefits of breastfeeding, what to expect while breastfeeding and more.

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Healthy Beginnings – Infant and Toddler Feeding

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Having a hard time understanding what, when, and how to feed your infant or toddler? Or maybe you’re looking for some additional tips and tricks to add to what you already know. We provide research-based answers to those tough questions

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When to feed infant cereal - tips for starting solids

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When to feed infant cereal - tips for starting solids

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Healthy Eating & Nutrition Introducing New Foods

How do I know baby is ready for solid foods? Look for these readiness cues

Does your baby:

Have good head control?

Sit up with help or support?

Bring objects to their mouth?

Seem interested in your food?

Move their tongue forward when their lips are touched?

Swallow their food rather than pushing it back out on to their chin?

If you answered "yes" to most of these questions, your baby may be ready for solid foods. Do not offer foods before 4 months, and waiting until after 6 months is also not recommended. Most babies are ready around 6 months. Talk with your pediatrician if you are unsure.

Tips for Starting Solids:

For those first attempts at eating with a spoon, pick a time of day when your baby is in good spirits, wide awake, and mildly hungry.

You might try a weekend morning, so there's no need to rush. A relaxed atmosphere increases your chances of having a successful first experience.

You can give baby some breastmilk or formula before their first solids so they are not uncomfortably hungry.

When mixing cereal, be sure to use breastmilk or formula. This familiar taste helps your baby accept the new taste of cereal.

Nutrition Counts with First Bites - All About Iron

Around the middle of the first year, babies need iron from the foods they eat - especially when they are breastfeeding. Iron-fortified baby cereals help provide this important nutrient that supports your baby's healthy growth and brain development.

Q: I'm just starting my baby on solids. What's a healthy balance between breastmilk/formula and solid foods?

A: Breastmilk or formula are baby's main source of nutrition, but foods need to be nutritious too. While baby's first solids are about the experience of tasting new flavors, experiencing new textures, and learning to eat from a spoon - they also should be nutrient dense foods like iron fortified infant cereals, pureed meats, and veggies and fruits prepared for baby.

Most babies continue their usual amount of breastmilk or formula when starting solid foods. As they get closer to their first birthday, more of her calories come from foods and breastmilk/formula intake may begin to decrease.

What's Ahead

Expose baby to a variety of grains and fruits. Once your baby is comfortable eating foods and has accepted a few varieties add more variety with single-grain cereals, mixed grain and fruit cereals.

Introduce baby to new tastes and textures. When baby begins to self-feed with fingers and begins to use their jaw to mash foods, they may be ready for new textures.

Gerber Lil' Bits Cereals have added texture to help babies learn to chew, mash and transition to table food and continue to provide the iron babies need from cereal for the whole first year.

Make Every Bite Count!

Our cereals have nutrients that babies need for growth and development.

Iron helps support baby's learning abilities.

Vitamin C Aids in iron absorption.

Calcium - the strong-bones-and-teeth builder.

B Vitamins help convert food into energy.

Vitamin E and Zinc help support baby's immune system and healthy growth.

Formulas that Nourish Happy and Healthy Tummies

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When to Feed Baby Cereal and Tips for Starting Solids

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Learn when to feed baby cereal and get some tips for starting solids, right here on Gerber Learning Center.

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Facts you should know about childbirth and delivery methods

Childbirth delivery options include natural unassisted childbirth, assisted childbirth, and delivery by Cesarean surgery (C-section).

Childbirth delivery locations include at home, in a birth center, or in a hospital.

Vaginal births without medication can be less painful, and smoother if the mother and partner learn breathing techniques and other strategies in a birthing class. Lamaze Method or the Bradley method are two common childbirth classes.

The risks and benefits of each delivery method must be weighed along with the mother's preferences to determine what is right for her.

Nearly 4 million babies are born in the U.S. every year. Childbirth care in the U.S. is very good. Less than 600 women die annually due to complications during childbirth.¹

Is childbirth painful?

Every woman's experience is unique but most mothers would honestly say, yes, childbirth is painful. However, it is short-lived, and there are many types and methods to effectively reduce the intensity of childbirth pain. There are many choices in childbirth. Women can choose the method that makes them most comfortable, and that makes sense for their personal and medical situation.

What natural childbirth methods are available at home?

Natural childbirth at home was the normal (and only) childbirth delivery option until about 75 years ago. Natural childbirth emphasizes an unrushed, supported process, with minimal interference and less invasive monitoring. Women who prefer an unassisted childbirth often attend classes to learn what to expect and how to be prepared. There are a number of different childbirth classes to choose. In any class, you learn about the stages of labor, breathing and relaxation techniques, what happens to the vagina after childbirth, and how to be prepared for the delivery and new baby. The different methods are taught in different classes.

10 Early Signs and Symptoms of Labor

While the signs and symptoms of impending labor are different for every woman; the signs and symptoms of normal labor can begin three weeks prior to the anticipated due date, and up until two weeks afterward. There is no precise way to predict exactly when a woman will go into labor. The 10 most common signs and symptoms of labor are:

1. An increased urge to urinate

2. The mucus plug dilates

3. Back pain

4. A burst of energy

5. Diarrhea...

What is vaginal delivery with no medication?

A vaginal birth without medication benefits both mother and baby. The microbiome, or bacterial environment, is established by birth method ². There is some research that suggests the development of the infant microbiome is associated with the likelihood of developing allergic diseases during childhood, but the association isn't clear.

Benefits of vaginal delivery

Infants born vaginally tend to have fewer respiratory problems.

Other benefits of vaginal delivery include a quicker recovery for the mother, and avoidance of abdominal surgery and the associated risks that come with a C-section.

Vaginal childbirth has a lower rate of infection and a shorter hospital stay.

Disadvantages of vaginal delivery

The disadvantages of a vaginal birth may include tearing of the perineum.

Sometimes, a vaginal birth may not be recommended for medical reasons.

What is a home birth?

Only about 2% of women in the U.S. opt for a home birth. It can be a safe and relaxing natural childbirth delivery method for women with a normal, low risk pregnancy. Home births are vaginal deliveries with no medication, and a variety of mind-body techniques and preparation methods are used to reduce childbirth pain and promote an easy labor and delivery

Home births are attended by a certified professional midwife, a licensed nurse midwife or a naturopathic midwife. Sometimes a support professional called a doula attends home births. These birth professionals also work in birth centers.

Benefits of home birth

Many women find it relaxing and comforting to be in their own home environment. Other advantages include:

Not having to worry about being transported to the hospital while in labor or being transported home after the baby's birth

Having a baby at home means having all of the comforts of home, including snacks and changes of clothing readily available.

The recovery and transition to breastfeeding can be easy because the environment is comfortable and familiar.

The mother can invite whomever she wants to attend the birth.

Many women feel more comfortable with home birth if they need to yell or vocalize.

Disadvantages of home birth

If special birthing assistance, such as a water birth tub, is desired, this will need to be brought to the home and prepared in advance.

If the home is very remote or weather is bad, it may be difficult for the midwife to reach the home in time (although it would be difficult to drive to the hospital in these same circumstances).

If the birth plan does not progress normally, it may require transport to a hospital.

Some women are not comfortable with a home birth, and it is not a good option unless it is a low-risk pregnancy, and the mother prefers it.

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See pictures of a growing fetus through the 3 stages of pregnancy See Images

What is the Lamaze method?

The Lamaze method is typically known for controlled breathing techniques but it includes a number of comfort strategies that can be used during labor. Breathing techniques increase relaxation and decrease the perception of pain. In addition to breathing, other information about preparing for childbirth is covered. Lamaze is taught in a series of classes attended by both the mother and her partner, when possible. The Lamaze method doesn't explicitly encourage or discourage medications, but seeks to educate women about their options so they can make a birth plan that suits their individual needs.

Benefits of the Lamaze Method

Lamaze training prepares the mother and her partner with a number of tools to use to get through labor and delivery naturally.

The breathing and relaxation techniques reduce the perception of pain and keep labor moving smoothly.

The Lamaze courses help the couple be prepared with what to expect over the first few days and weeks together.

Disadvantages of the Lamaze Method

What is the Bradley method?

The Bradley method focuses on preparing the mother for a natural childbirth coached by her partner. The emphasis is on being prepared for an unassisted vaginal birth without medication. The method is taught over 12 weeks along with reading a workbook. Midwives often recommend the Bradley method preparation classes. In addition to learning ways to reduce the pain of a vaginal birth, the method teaches about nutrition and other aspects of natural health.

Benefits of the Bradley Method

The Bradley method is beneficial to prepare parents for unassisted births.

It helps the couple be prepared with techniques to reduce the perception of pain and stay relaxed through a natural unmedicated childbirth.

It also teaches the couple about things they need to know to take care of themselves as new parents and what to expect when the infant arrives.

Disadvantages of the Bradley Method

For couples who are uncertain if they want to try for an unassisted vaginal birth without medication, the Bradley method might not be best. The course and training take quite a long time. Couples need to begin classes in the second trimester.

What is a water birth?

A water birth means the mother goes through some or all of the stages of childbirth in a portable tub similar to a hot tub. The baby can be delivered underwater or the mother can get out of the water and deliver in a different position. Women chose water births because it can be more relaxing, and less painful to be in the water. Birthing tubs can be brought into the home for a home birth, and they are often found in birthing centers. Some hospitals may have birthing tubs as well.

Benefits of water birth

A water birth is thought to be less painful and more relaxed for many women. It allows the woman to move into a variety of positions that can feel more natural and less painful.

The partner can also get into the tub with the mother to support the delivery.

Disadvantages of water birth

Some critics say a water birth can increase the risk of infection, but as long as the water is fresh and clean, water births are not any riskier than non-water births.

Unless the water birth takes place in a birth center with established tubs, there are logistics involved in setting up the tub and warming the water for a water birth.

If the birth plan at home does not progress normally, it may require transport to a hospital.

What types of childbirth and delivery methods are available in the hospital?

Women giving birth in the hospital have most of the same options as home births, she has quicker access to surgical interventions if an emergency occurs. Women giving birth in a hospital or birth center have the option to attempt a vaginal delivery with or without medication.

Benefits of hospital delivery

The benefits of a hospital birth include

ready access to emergency interventions such as a Cesarean section,

advanced monitoring for high-risk pregnancies, and

more pain management options including epidural anesthesia.

Disadvantages of hospital delivery

1. The risks of a hospital delivery can include a higher chance of unwanted intervention.

2. Sometimes the hospital setting can lead to rushing through the stages of labor, resulting in a higher chance of incision of the perineum during childbirth, and requiring a Cesarean.

3. Other risks of hospital childbirth (and any stay in the hospital) include a higher chance of infection.

QUESTION
See Answer

What are assisted births?

Natural births are not always an option, and if a complication develops, women now have a number of options to assist them with a safe birth. Sometimes C-sections are planned in advance. The other assisted options discussed here typically apply in the case of unexpected complications.

C-Section

According to the Centers for Disease Control (CDC), about 1/3 of births are delivery by C-section, although rates are highly variable by hospital and region. ³ The World Health Organization (WHO) says the rate of Cesarean deliveries should be about 10%-15%; the higher level is because of both elective Cesareans and overuse in the U.S. ⁴ A C-section involves a horizontal incision across the lower abdomen through which the infant is delivered. The typical hospital stay is three days after a Cesarean to ensure the incision is healing. Full recovery can take 8 weeks. One advantage of a C-section is that the delivery date can be planned ahead of time.

Vacuum extraction

A vacuum-assisted delivery involves attaching a soft cup to the head of the infant while it is in the birth canal and a hand-held pump is used to create suction to facilitate delivery.

The advantage is that this assisted birth option has a lower risk than a C-section of prolonged fetal distress.

The risks of this method include minor scalp injuries or more serious trauma or bleeding of the head.

Forceps delivery

A forceps-assisted delivery means that curved instruments are used to facilitate the progress of the infant in the birth canal. Forceps cannot be used if the infant is breech, but it can be an option if the mother is too exhausted or if the infant has to be delivered more quickly than is naturally occurring.

What about vaginal birth after C-section (VBAC)?

While it used to be considered unwise, women have the option to attempt a vaginal birth for their subsequent child after a C-section. Not all women are candidates for a vaginal birth after C-section (VBAC).

What types of childbirth delivery and delivery methods are available in a birthing center?

Some people consider a birthing center delivery the best of both worlds. The setting is relaxing and home-like, and mind-body support options for childbirth pain such as hypnosis, water births, and doulas are readily available. Unassisted deliveries using these support techniques are the focus. The emphasis is on ensuring the mother has the birth experience she wants. All of the labor and delivery options we have discussed thus far are available in birthing centers except C-sections. Typically, women are transferred to the hospital (or to a different part of the facility if the birth center is within a hospital) if they require an unexpected C-section.

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Medically Reviewed on 8/18/2020

Medically reviewed by Wayne Blocker, MD; Board Certified Obstetrics and Gynecology

REFERENCES:

Brumbaugh DE, Arruda J, Robbins K, Ir D, Santorico SA, Robertson CE, Frank DN. "Mode of Delivery Determines Neonatal Pharyngeal Bacterial Composition and Early Intestinal Colonization." J Pediatr Gastroenterol Nutr 2016 Mar 28. [Epub ahead of print] PubMed PMID: 27035381.

Switzerland. World Health Organization. "WHO statement on caesarean section rates." Apr. 2015. <http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/>.

United States. Centers for Disease Control and Prevention. "Pregnancy-Related Deaths." Jan. 12, 2016. <http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-relatedmortality.htm>.

United States. U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. Hamilton, B.H., et al. "Births: Final Data for 2014." Dec. 12, 2015. <http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_12.pdf>.

Complete List

Top 7 Childbirth and Delivery Methods Related Articles

Braxton Hicks vs. True Labor Contractions (Differences and Similarities)

Some pregnant women may mistake Braxton Hicks contractions (false labor) for real labor contractions, especially in the first pregnancy. Real labor contractions occur at regular intervals that become progressively shorter; more painful as labor progresses; are described as a tightening, pounding, or stabbing pain. Braxton Hicks contractions do not occur in regular intervals; do not become longer over time; and may disappear for a period of time and then return. Braxton Hicks contractions occur in third trimester of pregnancy, however, sometimes can occur in the second trimester. True labor contractions begin around your due date (unless your baby is preterm, in which you will be in preterm labor). So how can you tell the difference? Here are a few similarities and differences between Braxton Hicks contractions and True or real labor contractions.

Braxton Hicks contractions

Braxton Hicks contractions tend to become more frequent toward the end of pregnancy, and are not as painful as real labor contractions; do not occur in regular intervals; do not become longer over time; and may disappear for a period of time and then return.
Labor contractions
Frequently one of the early symptoms and signs of true labor is when the contractions begin to occur less than 10 minutes apart.
Real labor
Real labor contractions occur at regular intervals that become progressively shorter; more painful as labor progresses; are described as a tightening, pounding, or stabbing pain; may feel similar to menstrual cramps; and sometimes Braxton Hicks contractions can be triggered by dehydration, sexual intercourse, increased activity of the mother or baby, touching of the pregnant woman's abdomen, or a distended bladder.

Natural and home remedies to soothe and provide comfort for Braxton Hicks contractions include relaxation exercises like deep breathing or mental relaxation; change positions or take a walk if you have been active and rest; drink a glass of herbal tea or water; eat; or soak in a warm bath for 30 minutes (or less).

Preterm labor signs and symptoms When you have reached 37 weeks, and the contractions are more painful and are increasing in frequency you will have abdominal pain or menstrual-like cramping, an increase in pelvic pressure or back pain, and the contractions are more than four contractions an hour.

Doula vs. Midwife (Differences between Care, Costs, & Duties)

A midwife and doula are not the same thing. A doula's job is to provide non-medical, emotional, and personal support to a woman throughout her pregnancy, labor, delivery, and postpartum experience. A certified nurse midwife is a medical health care professional that manages the overall general health of the mother and baby; for example, performs exams, orders laboratory tests, and procedures, and performs fetal monitoring from the pregnant woman's first prenatal visit to post-partum and aftercare. A midwife can deliver the baby, whereas a doula cannot.

A midwife usually tries to minimize the use of unnecessary technological interventions. A midwife cannot perform C-sections, use vacuums or forceps during labor and delivery. Midwives generally work with an Obstetrician (a doctor that specializes in pregnancy, birth, and women's reproductive health) when medical intervention by a specialist is necessary.

A doula does not require a medical degree, but requires certification in some states. Certification for nurse-midwife in the US requires a certification from the American Midwifery Certification Board (AMCB). Entrance into the AMCB program requires a Bachelor's Degree and a licensed RN degree. AMBC certification is a Master's Degree program.

REFERENCES:

Government of the District of Columbia. "Municipal Regulations for Nurse-Midwives."

Oregon Health Authority.gov. "Utilizing Doulas to Improve Birth Outcomes for Underdeserved Women in Oregon." Feb 22, 2012.

American College of Nurse-Midwives. "Become a Midwife."

AMCB.org.

Pregnancy Planning (Tips)

Pregnancy planning is an important step in preparation for starting or expanding a family. Planning for a pregnancy includes taking prenatal vitamins, eating healthy for you and your baby, disease prevention (for both parents and baby) to prevent birth defects and infections, avoiding certain medications that may be harmful to your baby, how much weight gain is healthy exercise safety and pregnancy, travel during pregnancy.

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Childbirth Methods: Natural, Assisted, C-Section, VBAC

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Facts you should know about childbirth and delivery methods Childbirth delivery options include natural unassisted childbirth, assisted childbirth, and delivery by Cesarean surgery (C-section). Childbirth delivery locations include at home, in a birth center, or in a hospital.

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By Nicholas Andrews, MD, PhD

Nicholas Andrews, MD, PhD

Health care providers have lots of ways to keep you focused and safe during labor and delivery. But one person often provides more benefits than your doctor or nurse: your support person.

Having a dedicated labor support person-someone not on your health care team-is so important. Research shows that women who have continuous labor support are less likely to use pain medications or have C-sections. They also tend to have shorter, more satisfying birth experiences.

At UNM Health, we think it's so important for women to have labor support that, even with limited visitors during COVID-19, we've prioritized allowing each patient to have a support person in the delivery room.

Giving birth is one of the most important days of your life. Your labor partner can do a lot to make it the birth experience you envision. Their role is to help you focus, manage your pain and encourage you during what can feel like a marathon.

Let's talk about how to build the perfect support system, how a labor partner can help you prepare for childbirth and their role in the delivery room.

4 Questions to Ask About Support Person Options

When choosing who will be your primary labor support person, the first step is to have a frank discussion. Being present for the birth of a child is different from being an active support person. You want someone who will be ready and able to help you through a challenging and painful-yet joyous-experience.

When thinking about labor support, most people assume it will be the woman's spouse or partner. That is often the case. But while the partner is often present, the primary support person may be the patient's mother, sister or best friend, or a doula.

Think about these questions as you consider who should join you in the delivery room:

1. Is your partner right for the job?

Many partners are wonderful primary support people during labor and delivery. But some aren't, and with good reason. It can be difficult for your partner to see you in pain. And, if they faint at the sight of blood, consider finding someone else to be your support person. You don't want to be worried about your partner while you are trying to focus on having your baby!

If you choose a different support person, your partner can still be in the room, and as involved as you both would like. Or they can wait in the waiting area-whatever makes you both comfortable. Before, during and after childbirth, there are still plenty of ways your partner can support you.

2. Would you prefer support from an experienced mom?

Some women find it comforting to have another woman with them, especially someone who has given birth before. They can tell you what to expect and answer a lot of your questions.

For some families, it's a cultural custom to include a female relative in your labor and delivery. For much of history, in fact, childbirth was a female-only event. A woman's female relatives and friends would help her, along with a midwife. Fathers were often asked to boil water or fetch towels (probably to get them out of the way!) but they typically didn't attend the birth. Talk with your family and your OB/GYN or midwife about the best options for you.

3. Do you prefer a doula?

Another support option that is becoming more common are doulas. These trained companions provide emotional, physical, and educational support to women during pregnancy, labor, delivery, and after birth.

At UNM Hospital, we recognize the benefits that women can reap from doulas, so we started a volunteer Birth Companion Program that offers free birth companions to incarcerated, uninsured and under-served Medicaid patients who deliver their babies here. This program is on hold during the COVID-19 pandemic. However, we will start the program again as soon as it is safe.

Related Reading

What Does a Doula Do? Plus, Tips to Find Your Perfect Match.

4. How many people are allowed?

During COVID-19, in-room visitors are limited. But even in normal times, it's not always safe to have a large number of people with you in the delivery room.

We want you to have everyone with you that you want, but the health care team needs room to work. Things can change quickly in the delivery room. If an emergency happens, we need clear paths and fewer people to get out of the room.

Before you ask multiple people to be in the delivery room with you, talk with your nurse-midwife, family medicine physician, or OB/GYN how many people are allowed.

In some cases, having a cap on people might work to your advantage. Some patients want just one person with them, but several loved ones want to attend the birth. Your provider can deliver that message for you, and they can blame it on us!

Support Before Childbirth

Now that you've found the perfect support system, let's look at a few ways they can assist you before, during, and after childbirth.

Before Childbirth

There's no such thing as too much preparation. Even if you have already had a baby, there's always something new to learn. This goes for your support person as well.

Ask your support person and/or partner to accompany you to prenatal exams and childbirth classes to learn about relaxation techniques and labor positions. Your support person also can watch videos or read articles or books about how best to help you.

Discuss your birth plan with your support team so everyone is on the same page. That way, they can help advocate for your preferences while you're in labor.

Finally, take a tour of the labor and delivery unit together and pack your overnight bag for your hospital stay. Make sure your support person has their phone handy so they're ready to go when contractions begin.

During Labor & Delivery

Once contractions begin, your support person can jump in and start timing them. The closer together the contractions are, the closer you are to having your baby. Talk with your health care provider in advance about when you should leave for the hospital.

Labor can take a while. Your support person can go a long way in helping pass the time. Together, you can play cards or a board game, watch a movie, or walk the halls.

When contractions become more frequent and intense, your support person can guide you through the breathing and relaxation techniques you have practiced. They can also help you move into different positions to relieve some discomfort. Your support person can help you get into a warm tub, massage your back, or simply offer a hand to squeeze.

Through it all, they should keep encouraging you-calming, positive words can be a big motivator. And they should be flexible. If you want them to stop or start doing something, tell them. Their role is to help you however they can, including helping you communicate with the health care team.

After the Baby Is Born

Once you've had your baby, you deserve and need rest. Your support person can take charge of updating family on the good news and help keep track of information about newborn tests and vaccines that are given after birth.

When you get home, ask for and accept help from family and friends. Let them watch the baby for a few hours while you shower, take a walk, or nap. Don't say no to offers for prepared meals or helping with laundry.

Your support person can also help watch for signs of postpartum depression and anxiety-both of which are common after giving birth. They can help you get the care you need to start feeling like yourself again.

When it comes to pregnancy, labor, and delivery, mom and baby are the stars of the show. But every star needs a strong supporting cast member or two. Find and enlist the person who will be your rock and help you through one of the most joyous moments life can offer.

To find out whether you or a loved one might benefit from Ob/Gyn care, call 505-272-2245.

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Who Should be in the Delivery Room? How to Choose the Best Labor Support Person

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By Nicholas Andrews, MD, PhD Health care providers have lots of ways to keep you focused and safe during labor and delivery. But one person often provides more benefits than your doctor or nurse: your support person. Having a dedicated labor support person-someone not on your health care team-is so important.

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How Much Sleep Do Babies Need? Baby Sleep Hours by Age

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When it comes to how much sleep babies need, there is no one-size-fits-all answer. Here’s the recommended amount of sleep your baby should get based on age.

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Does my baby have colic? Understand what is considered a normal crying pattern and how to identify colic in your baby.

Crying, difficult as it is to hear, is a normal way babies communicate hunger, discomfort, distress, or a need for your attention. Most newborns reach a crying peak at about 6 weeks. Then their crying starts to decrease. By 3 months, they usually only cry for about an hour a day. This is what is considered a "normal" crying pattern.

Then there's colic. Although all babies cry, some babies cry much more than others. This is a condition known as "colic." It is defined as crying that:

begins and ends for no obvious reason

lasts at least 3 hours a day

happens at least 3 days a week

continues for 3 weeks to 3 months

Although the cause of colic is unknown, the condition is temporary and won't impact your child's development. If you are concerned about how much or how intensely your baby cries, talk with his health care provider.

Consider Your Family

Thinking about the following questions can help you adapt and apply the information and strategies below to the individual needs of your child and family:

When you think about your baby's crying, are there particular experiences or situations that you find upset her more than others? Why do you think that is? How does this help you understand her better?

What calms your baby? What have you tried that has worked? What does this tell you about your baby?

It is important to tune in to your own reaction to your baby's crying. How it affects you impacts your ability to soothe her. Some parents are more distressed by their baby's crying than others. How do you feel when your baby cries? Do you find yourself getting very upset yourself when your baby cries? If so, how do or can you calm yourself?

Baby Blues and Postpartum Depression

Having a baby who is difficult to comfort can increase parents' stress and can contribute to the "baby blues" and/or "postpartum depression." As many as 50%-80% of new mothers experience the baby blues in the first 10 days after childbirth. Symptoms may include tearfulness, fatigue, difficulty sleeping, and feelings of loss. The baby blues usually get better after about 10 days.

Approximately 8%-15% of new moms experience postpartum depression in the first year of motherhood, which is different from the blues. With depression, symptoms last more than 2 weeks and include feeling down and hopeless, increased crying, feeling little pleasure or interest in activities one used to enjoy, and loss of energy. If you are experiencing these feelings, it is very important-for you and your baby-that you seek help from a trusted health professional.

How to Comfort a Fussy Baby

Observe and Learn

Identifying, as best you can, the reason for your baby's crying will help you figure out how to respond to him in the most sensitive and effective way. The following questions can help guide you:

Are there certain times of day when your baby is fussier?

Are there specific situations that lead to crying such as visits to busy, noisy places (think grocery store) where your baby is overwhelmed by all of the stimulation?

Are there differences in her cries for hunger, fatigue, boredom, anger, feeling overwhelmed? For example, many babies will look away and arch their backs, in addition to fussing and crying, when they are overstimulated and need a break from play and interaction.

More specifically:

Is your child sick? Teething? Tired? Hungry? Sad? Mad?

Has there been a recent change in his world that may be making him feel less safe and secure overall? Perhaps he recently made the switch from bassinet to crib, or nana has just left after a long visit.

Is your child's fussiness mostly around feeding? For example, does your baby tend to take a few sips from the breast or bottle, then arch her back, cry or fuss, and turn away? (This may indicate a cow's milk protein sensitivity. Talk with your medical provider about what you are seeing to determine next steps.)

Frequent irritability (that is worse after meals and when lying down), back arching, stiffening of the legs, and head turning may be symptoms of reflux. If you are seeing these symptoms, it is best to consult with your child's health care provider to determine the appropriate response.

Respond Based on Your Best Understanding of the Behavior

There is not one right way to soothe a baby. Some babies love to be rocked when upset; others find that too stimulating and prefer to be walked slowly while in a baby carrier, snuggled close to a parent's chest. Other babies are calmed by being put down in a safe place where they can take a break from the intensity of the world.

It's a process of trial and error. No one is perfect, and you don't have to be. When a strategy doesn't work, don't blame yourself. Try something else until you discover what works for your individual baby in that specific moment in time. (A strategy that didn't work yesterday may work today.)

The fact is that sometimes, after trying every strategy you can think of, you will still not be able to comfort your baby. We all have had this experience. Being with a crying baby who is difficult to soothe can be exhausting, stressful, and frustrating. Keep in mind that just by being there-holding and comforting your child-you are teaching her that she is not alone and that you will stick by her through thick and thin.

Look for ways to support your baby and yourself:

Swaddle your baby. Some babies cry less when they are wrapped snugly in a blanket-called "swaddling"-and gently rocked.

Use a baby carrier. Being held close as you go through your day can be very soothing.

Try different ways to hold your baby. Some babies love to be snuggled tightly against their parent's chest. Some like to be able to look over their parent's shoulder. Others prefer to be held faced away from you. Many respond well to the "football hold," when a parent cradles her baby in her arms like a football. There is no right or wrong way as long as your baby is safe.

Use soothing sounds. Talk or sing softly to your baby. Background noise can be soothing. Try running a fan or humidifier in your baby's room.

Try different kinds of movement. Some babies find gentle, slow movements like swaying soothing. Others actually are calmed by more vigorous movements such as swinging or faster rocking.

Offer a pacifier or other safe object to suck. Some babies have a very powerful need to suck and find this action very soothing.

Reduce stimulation-lights, sights, sounds, and textures-for your baby. Sometimes less stimulation leads to less crying, especially for babies with colic.

Give your baby a break. When nothing works to soothe your baby, give your baby a chance to try to soothe herself by putting her down in a safe place for 5-10 minutes. In fact, sometimes our efforts to comfort our babies actually overstimulate them and increase their distress, rather than soothe them. Putting them down can actually be calming. Babies sometimes need a break from touching, talking, and interacting. If your baby doesn't calm down, no harm is done. You have gotten a few well-deserved minutes to rest and might have a little more energy to care for your baby.

Remember the crying will end. Usually the worst of crying and colic is over by the time your child is 4 months old. If your baby does have colic, it does not mean that he will be a difficult toddler. Colic will end.

Beware the quick fix. Cereal in the bottle? Colic drops? Rubbing something on baby's gums? There in no evidence to show that these strategies work. There is no "magic wand" to stop crying. However, if you do decide to try a quick-fix remedy, check with your child's health care provider first to be sure it is safe.

Soothe yourself. You deserve it. Caring for a crying baby can be very stressful. But when you take the time to calm yourself, it helps your baby calm down too. If you find yourself feeling really frustrated, put your baby in a safe place-like the crib-and take a short break to give yourself the time you need, and deserve, to take a deep breath and calm down.

Share your feelings. Talk to your partner, friends, and family. Look for parent or parent-child groups. In some communities there are also child development centers that provide support and guidance to parents struggling with their infants' excessive crying. It can be very helpful to talk to other parents coping with similar challenges both to feel less alone and to share ideas and strategies. Ask your health care provider about these resources.

Get as much sleep as you can! Sleep deprivation makes everything more difficult. So try to get the sleep you need. Nap when your baby naps. When another caregiver can watch your baby, go back to sleep. The grocery shopping, housecleaning, and e-mails can wait.

Knowing When to Seek Help

How are you feeling right now? Coping with crying can be very challenging. What do you need to feel supported? How can you get this kind of support? Are there friends or family who can help out? Is there a community resource for new parents where you can go for support?

Although crying is they primary way babies communicate, and they are not doing it to make you feel badly, it can be very difficult to take over long periods of time. When babies cry a lot, it can feel like nothing positive is happening between the two of you. Watch your baby carefully. How do you see your baby responding to you in positive ways? For example, does he follow you with his eyes, or prefer to be held by you? Does he turn toward you when he hears your voice, or calm when he sees you coming? Soon, if not already, you will even be getting some smiles!

When to Seek Help

There are times when it is important to seek out the guidance of a trusted health care provider or child development professional to be sure your child's development is on track. You and your baby need support during what can be a difficult time. Moments in which you and/or your child might need some extra help include:

If you do not feel bonded to your child because of her crying.

If you worry that you may hurt or harm your child (or yourself).

If your baby is taking in less milk or formula (his feeding patterns have changed) or has lost weight.

If your child seems to have a strong negative response to sensory stimulation like touch, noises, lights, smells and tastes, textures, or movement in space. (He may be frequently irritable or fussy when exposed to new or strong sensory information.)

If your child's crying began after she experienced a life change (such as a new caregiver) or following a frightening or traumatic experience.

Even if you or your child is not experiencing the kinds of challenges described above, it can be very helpful to talk to a child development professional who can provide guidance and support during this stressful period.
This resource was made possible by generous funding from the Carl and Roberta Deutsch Foundation.

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Does my baby have colic? Understand what is considered a normal crying pattern and how to identify colic in your baby. Crying, difficult as it is to hear, is a normal way babies communicate hunger, discomfort, distress, or a need for your attention. Most newborns reach a crying peak at about 6 weeks.

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Crying for Comfort: Distressed Babies Need to be Held

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Article by Aletha Solter, Ph.D., founder of The Aware Parenting Institute and author of five books.

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October is Safe Sleep awareness month! Did you know that the way your baby sleeps could put them at risk of an unsafe sleep death? Every year, about 3,500 babies in the United States die because of unsafe sleep. Keeping your baby safe while they sleep is simple if you follow the ABC'S of infant safe sleep. Learning about safe sleep is important for moms, dads, grandparents, aunts, uncles, babysitters, childcare providers, and more! Anyone caring for a baby under one year old should follow the ABC'S of safe sleep.

A is for ALONE.

Babies should sleep alone. That means without other people and without blankets, toys, or pillows. These objects could get caught in front of a baby's nose and mouth and make it hard for them to breath. People sleeping in the same bed as a baby could suffocate or smother the baby. The safest way to sleep is alone.

B is for BACK.

Babies should be put to sleep on their backs. This is the safest position for a baby to sleep. In the past, we didn't have as much evidence as we do now that back sleeping is the safest sleep position. Many babies used to sleep on their stomachs because we didn't know better. Now, the science is clear: Back sleeping is safest.

C is for CRIB

Babies should sleep in a crib, bassinet, or playpen. These are the only safe places for a baby to sleep. Beds, couches, and chairs are dangerous places for a baby to sleep.

S is for SMOKE-FREE

There should be no smoking in the area where your baby sleeps. This means no cigarette or marijuana smoking. Smoke particles can get trapped in your baby's bedding and clothes and make it hard for them to breath while they sleep.
Learn more about what a safe sleep space looks like.
Sometimes, other people caring for your baby might have different opinions on how babies should sleep. This is a hard situation to be in. Everyone caring for your baby wants the best for your baby, so have conversations about safe sleep with these people early and often.

Thank the person caring for your baby.

Tell the person you are grateful that they can help care for your baby and that they want to be part of baby's life.

Find common ground.

Even though you and another caregiver might have different opinions on how babies should sleep, you both have the same goal: keep baby safe and healthy. Make it clear to this person that you are on the same team trying to keep baby healthy. Make sure they know you want to work together to keep baby safe.

Ask for consistency.

Tell the person caring for your baby that you are trying hard to be consistent with how the baby sleeps and you can really use their help.

Share the facts.

Share factual information about safe sleep. The science is clear, the ABC'S of safe sleep help prevent infant deaths. Share this resource to help caregivers learn the facts.

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Follow the ABC'S of infant safe sleep to prevent infant deaths

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October is Safe Sleep awareness month! Did you know that the way your baby sleeps could put them at risk of an unsafe sleep death? Every year, about 3,500 babies in the United States die because of unsafe sleep. Keeping your baby safe while they sleep is simple if you follow the ABC'S of infant safe sleep.

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October is Sudden Infant Death Syndrome Awareness Month. Pediatricians make it a point to discuss how SIDS can be prevented at all newborn and infant wellness visits.

Since 1992, when the American Academy of Pediatrics began the "Back to Sleep" campaign, the annual rate of SIDS has dramatically gone down compared to previous years. By adopting policies encouraging non-prone sleeping the first year of life, other countries have seen similar reductions in cases during the same time period. Sadly, it remains the leading cause of infant mortality in the United States.

Sudden Infant Death Syndrome was first defined in the late 1960s. It describes the sudden death of an infant "under one year of age which remains unexplained," despite a thorough investigation.

The syndrome has also been known as "crib death" or "cot death." It is currently theorized accidental suffocation may be a cause of, or significant factor in, most sleep-related cases of SIDS. It is also felt infants who were victims of SIDS most likely had an unidentified vulnerability (such as genetic or brain abnormalities).

Studies have established that SIDS more commonly affects infants who are born prematurely or whose mothers did not get regular prenatal care. Studies have also shown there is no increased risk of SIDS associated with vaccines. In fact, since the mid-1980s, while the number of available vaccines has risen steadily, more than halving the number of SIDS cases.

Parents can do several things to prevent SIDS from affecting their children. No monitoring system or test yet exists to accurately predict a baby's risk. But several strategies now have a proven track record over several decades.

During pregnancy, it's best if the mother receives regular prenatal care and abstains from smoking. After the birth, it's safest for babies to be placed on their backs to sleep. Room-sharing, but not bed-sharing, is recommended, as it is shown to decrease the risk of SIDS. A firm sleep surface, free of soft objects such as stuffed animals and pillows, is optimal for keeping the child's airway free and reducing the risk of overheating.

It's helpful to remember, the guiding principles behind the safe sleep ("Back to Sleep") practices are: keep the infant's airway free from obstruction; don't do anything to decrease the child's arousal, which overheating can do.

Additional recommendations for parents: do not smoke; do not use car seats, strollers or swings routinely for sleep. If the child falls asleep in one of these devices, they do not need to be woken up and removed, but should be supervised by an adult.

Other factors shown to protect against SIDS are breastfeeding; a fan in the bedroom, or maintaining a temperature of about 65 degrees Fahrenheit in the bedroom when the child is sleeping to avoid overheating and diminishing the child's arousal.

The use of a pacifier is also recommended. It is believed the pacifier decreases the risk of SIDS by maintaining an open airway, thus decreasing the chance of suffocation.

Home monitors are not recommended because studies show them to be ineffective and often inaccurate, which can become a significant cause of unnecessary stress for parents.

Unfortunately, SIDS still affects approximately 4,000 infants a year in the U.S. But this is much less than annual rates predating the campaigns strongly recommending the safe sleep practices described above.

If you would like to learn more about SIDS and safe sleep, visit your baby's pediatrician for regular well visits. You can also learn more by visitingsids.org/.

newborn SIDS infant American SIDS Institute Infant Death Syndrome Awareness Month infant wellness

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October is Sudden Infant Death Syndrome Awareness Month. Pediatricians make it a point to discuss how SIDS can be prevented at all newborn and infant wellness visits. , The official News page of the Air Force Medical Service, providing the latest articles about Air Force Medicine and the Air Force.

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Giving birth can be both exciting and terrifying for first-time moms. Just as the rest of your pregnancy has differed from others', your birth experience will be unique to you and your baby. As you think about the big day when you'll finally meet your little one, you probably have questions about what to expect!

Here are some of the most common questions I've been asked about giving birth for the first time.

Getting Ready for Baby

How important are birthing classes?

Prenatal classes or birthing classes can help you understand what to expect during your labor and delivery. You'll learn about creating a birth plan, common things that happen in a hospital, and how to manage pain. At Madison Women's Health, we refer our patients to Unity Point Meriter for prenatal classes. You can begin taking prenatal classes at the start of your second trimester. We recommend completing them before your 37th week of pregnancy.

Prenatal classes can be online or in person. Check with the hospital to see what they currently offer. Prenatal classes typically include a birth center tour. There are classes for singletons and multiples. They are helpful in understanding various things that can happen in labor and delivery that are not common things you see on TV (like ways to monitor your baby's heart rate and the use of forceps or a vacuum if needed to safely deliver your baby).

Tip: Prenatal classes will help you think of questions you may want to ask your OB during your prenatal check-ups. Keep a list! Classes are a good supplement to your 10-15 minute prenatal visits.

Who can be with me at the birth?

Before the COVID-19 pandemic, there were no restrictions on how many people could be with you during the birth. During any Public Health Emergency, guidelines may change. It's always a good idea to verify how many people can be there with you.

At the time this article was written, Meriter allowed one support person (in addition to a doula) to be with you. This person can be anyone - your partner, a friend, or a relative. Choose someone who will be supportive and encouraging. Currently, your support person must be the same person throughout the birthing experience. In other words, your support person cannot be your spouse for a few hours, then your mother, and then your sister.

Tip: A doula is considered part of the medical team and is therefore allowed to be involved in your care during the pandemic.

What is the difference between a midwife and a doula?

Midwives have been trained in obstetric procedures. They can interpret fetal monitoring, make recommendations on labor management, and recommend a C-section if it is needed.

Doulas have been trained in the emotional, psychological, and physical support of moms throughout pregnancy, delivery. and postpartum. They have not been medically trained, but their attention and focus on the mom has been shown to improve birth outcomes. Women who use a doula are more likely to have a delivery without pain medications and their labors tend to be shorter.

Tip: A doula does not make medical recommendations or replace your midwife or doctor, but rather they offer extra services and individualized prenatal and labor support

What will the labor and delivery room or birthing room look like?

Our patients deliver their babies at Meriter Hospital, which has large birthing rooms. You'll appreciate having more space to walk around in early labor or sit on a birthing ball. You'll be able to control the temperature and dim the lighting. Your room will have a couch, perfect for your support person to nap on if needed.

Tip: Meriter's birth rooms also include a comfortable tub. While we don't offer water births (in accordance with ACOG recommendations), water immersion during labor can help with relaxation and easing labor pain.

What should I pack in my hospital bag?

If you have to drop what you're doing and immediately go to the hospital, they will have all the essentials. I usually tell patients, however, that it's a good idea to have a bag ready to go around 36 weeks. There are things you will want to help make your stay more comfortable.

Here are some ideas for your hospital bag:

Toiletries: Shampoo, conditioner, soap, toothbrush and toothpaste, hair brush, deodorant. While we have these things at the hospital, you'll probably prefer your own.

Comfy clothes for you.

Slippers, socks, or flip-flops.

Robe and/or nightgown. If you plan to breastfeed, choose a nightgown that opens in the front (although the hospital ones are great for this!)

Clothes to wear home. Comfortable maternity clothes are usually your best bet. Include a nursing bra if you plan on breastfeeding.

Going home outfit for your baby. Your baby will be swaddled and diapered during the hospital stay, but most parents want a photo-worthy outfit for the big trip home.l

Snacks for your partner / your support person. The hospital has a cafeteria (open during the day) and vending machines, but your partner may want to consider anything special they want. Sometimes light snacks are okay in early labor, but we recommend against eating in active labor for safety reasons (and you usually won't feel like it!).

Phone charger. Family and friends will want frequent updates and you will fill up your camera roll quickly.

It's Time!

At what point do I need to go to the hospital? How long should I labor at home?

Most women can spend time in early labor at home. We recommend calling if you have painful contractions every 5 minutes for 1-2 hours to keep us in the loop. Call sooner if your doctor has given you more specific instructions due to medical conditions. If you have had a more complicated pregnancy or if you live far from the hospital, you may be asked to come in sooner. If you think your water has broken, we recommend calling to discuss the best time to come in, which is usually early for safety reasons.

Tip: Everyone has a different pain threshold. A good measure of "painful contractions" means you need to stop and breathe through them without focusing on anything else.

How long is labor for first-time moms?

There are three stages of labor and how long each lasts is very unpredictable for first-time moms. The whole event can last hours or days. Your first labor will be the most unpredictable, while second labors are generally faster.

What are the stages of labor?

Stage 1a: Latent Labor

Contractions during early labor will feel mild, like deep menstrual cramps, and will be irregular. Early labor helps soften, shorten, and thin your cervix. It can start a few days or a few hours before birth.

Stage 1b: Active Labor

During active labor, your contractions become more frequent, regular, and painful. You are considered to be in active labor when your cervix has dilated to 6 cm. The rate of cervical change is more consistent and predictable from this point to "complete" dilation (10 cm). Your doctor will check your cervix to let you know when it's ok to begin pushing. If you push too soon, before your cervix has fully dilated, you are at risk of tearing your cervix and having significant bleeding.

Stage 2: Pushing Stage / Birth

The second stage is the pushing stage. This stage can last a few minutes or many hours (up to 4 or more if the baby is making progress through the birth canal).

You may think, "how will I know when to push?" If you don't have an epidural during labor, the urge to push is often very strong. If you have an epidural, you may not notice the urge to push in the same way. We will help you know how and when to push with your contractions.

Stage 3: Placenta Delivery

The placenta generally delivers within 30 minutes of giving birth. We sometimes massage your uterus to help with this (although we say massage, this can be uncomfortable). We strongly recommend every woman receive oxytocin as well. These steps are important to decrease the risk of excess bleeding following delivery.

What should my partner do during labor?

Talk about this with your support person ahead of time so expectations are clear. Some women prefer their partner help with coping with labor pain. Others prefer a more hands off approach. Talk together ahead of time to determine what you are comfortable with.

Tip: Your support person can be supportive in many ways. This can be giving you sips of water and ice chips, holding your hand, being responsible for music, rubbing your back, etc. Do what works best for both of you.

Can I eat and drink while I'm in labor?

If you are undergoing an induction or are at the hospital in early labor, sometimes light snacks are reasonable. A lot of women get nauseous and throw up in labor and are at risk for aspiration, a serious complication. We therefore recommend against eating in active labor. If there's a possibility of needing a C-section, it is safest to have not had food recently. Most women are not hungry anyway! Water, clear juice, and ice chips are satisfying.

Tip: If you have an I/V, you will be properly hydrated. If your lips get dry from your breathing exercises, ask for some chapstick.

Pain Management

What does giving birth feel like?

Labor pain feels different for everyone, but some general principles include:

Braxton Hicks contractions - These are common, even as early as the second trimester. You'll feel your uterus gradually tighten and get soft. This is not painful.

Early labor - Contractions can feel like strong menstrual cramps lasting 30 to 60 seconds (like a charley Horse in your uterus). Some women feel these contractions in their back.

Active labor - These are cramps that can't be described by words. You may feel intense pelvic pressure as you "transition" to 10 cm and your baby descends into the birth canal.

Pushing stage - Along with the muscle pain of contractions, you will feel stretching and pressure in your vagina.

What are my options to treat labor pain?

Non-Pharmacologic Pain Control:

Changing positions: You may feel better standing up, resting on your hands and knees, or sitting on a birthing ball. Your body will tell you what is working!

Taking a warm shower or bath: The warm water can relax tense muscles. Water immersion has been shown to lower pain scores.

Massage: Your support person, nurse, or doula can massage your back and provide counter pressure during contractions

Breathing techniques: You'll learn breathing techniques during your prenatal classes. Staying relaxed and calm helps with pain control.

Pharmacologic Pain Control:

I/V Narcotic: Some women have good pain relief with an IV or subcutaneous injection of a narcotic medication. We don't recommend this option if we suspect you will deliver within an hour. This is to let the medication clear from you and your baby's system before delivery. .

You can request an epidural at any time you are in pain in labor. Some women request an epidural almost immediately, while others choose to have it done later. Medication from an epidural does not transfer to the baby. Learn more FAQs about epidurals for labor pain.

Tip: Each woman has different anatomy and experiences pain differently, so please be careful not to put pressure on yourself to make decisions about your labor based on others experiences. Women who give birth with an epidural have no less of a "natural birth" than someone who did not use pain medication. Each birth is equally as beautiful!

Special Circumstances & Preparing for Unexpected

What about giving birth to twins? How is labor different?

We recommend twins be delivered in an operating room instead of the birth room, even if delivered vaginally. While it may not feel as cozy as a birth room, an operating room allows for more room to meet these babies safely. Your OB/GYN will counsel prenatally on the safest way to meet your twins, as having two babies at one time comes with more risk than one.

In the United States, the primary Cesarean section (C-section) rate is just over 30%. At Madison Women's Health, the C-section rate for first-time moms is well under 20%.

What is the likelihood I will need a C-Section?

In the United States, the primary Cesarean section (C-section) rate is just over 30%. At Madison Women's Health, the C-section rate for first-time moms is well under 20%.

In the United States, the most common reason a woman delivers by C-section is that labor does not progress. In most cases, this is due to cephalopelvic disproportion (when a baby does not fit). The second most common reason is because we see signs a baby is in distress in labor. The recommendation for C-section is made when the benefit of meeting a baby by surgery outweighs the risks.

Tip: Our primary goal in caring for you is a healthy mom and a healthy baby and we will explain our recommendations for that each step of the way. We also want you to have a vaginal birth! We only recommend C-sections if we think the benefit is greater than the risk.

What is an episiotomy? Will I need one?

An episiotomy is a rarely performed medical procedure that involves cutting the perineum to help the baby deliver. Historically, an episiotomy was thought to decrease severity of tearing with delivery. We know through research that letting tearing happen naturally is more beneficial to the mom.

Tip: Episiotomies are only performed in emergency situations, with your consent, when it will help the baby deliver more quickly (a rare occurrence).

Will I tear? How is it treated?

Approximately 90% of women have a vaginal/perineal tear with delivery. Tears are graded as 1st through 4th degree, with 1st as the least amount of tearing. We recommend suturing tears to help them heal appropriately. We do this with stitches that dissolve.

Tip: A new technique, called perineal massage, has been proven to decrease the amount of tearing with delivery.

What about the embarrassing things....like pooping and pubic hair?

Most worry or feel embarrassed about these things, but we don't even notice!

If you like to wax, I don't recommend this past the 37th week. We don't recommend shaving before delivery because it increases your risk of infection. Trust us, we are not paying attention to grooming!

Most women will have a bowel movement in labor or with pushing. This is good! it means you are pushing correctly.

Tip: Trust us. We really don't care or remember!

Recovery

How long does it take to recover from giving birth?

Every woman is different in how she recovers, too. Postpartum is an awesome time, but also stressful! It is often referred to as the 4th trimester. Your sleep schedule changes, your body changes, and your interpersonal relationships change. If you choose to breastfeed, read up on our breastfeeding tips for new moms.

Vaginal Birth:

Many moms are surprised to know there is still a recovery period. You may have cramping, tailbone pain, and pain as a tear heals. Sometimes sitting and walking are tricky! There are no true lifting restrictions after a vaginal delivery, but I recommend avoiding heavy lifting for about two weeks, especially from the ground. This puts a lot of stress on your pelvic floor as it heals. Helpful tips for going home include sitting on soft surfaces, using a spray bottle after you void, using ice pads, taking ibuprofen and Tylenol, and keeping an area of all the things you will need most to care for you and baby in your home.

C-section:

The recovery from a C-section is longer because it is a major surgery. Wait six weeks before lifting anything greater than 10-15 lbs. We will teach you how to care for your incision in the hospital and will send you home with pain medication.

Final Recommendations

What are your recommendations about giving birth at home?

Home births double your risk of complications, with two times the risk of perinatal mortality and three times the risk of neonatal seizures. We, along with the American Academy of Pediatrics and ACOG, believe the hospital is the safest place to give birth. If you decide to give birth at home, you should have a low-risk pregnancy, the help of a certified midwife, and be reasonably close to a hospital.

Tip: Our first priorities are the health and safety of you and your baby. We will give you information and recommendations about safety and labor so you can make informed decisions throughout the process.

Bring a list of questions to your next OB visit!
Dr. Ashley Durward has been providing healthcare to women in Madison since 2015 and joined Madison Women's Health in 2019, specializing in high and low risk obstetrics, contraception and preconception counseling, management of abnormal uterine bleeding, pelvic floor disorders, and minimally invasive gynecologic surgery.

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Giving Birth: Labor & Delivery Tips from an OBGYN for First-Time Moms

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Giving birth can be both exciting and terrifying for first-time moms. Just as the rest of your pregnancy has differed from others', your birth experience will be unique to you and your baby. As you think about the big day when you'll finally meet your little one, you probably have questions about what to expect!

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Ideal foods and fluid intake during pregnancy

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Ideal foods and fluid intake during pregnancy

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The Academy of Nutrition and Dietetics recommends the following key components of a healthy lifestyle during pregnancy: To maintain a healthy pregnancy, approximately 300 extra calories are needed each day. These calories should come from a balanced diet of protein, fruits, vegetables and whole grains. Sweets and fats should be kept to a minimum.

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Vegetarian, vegan and special diets in pregnancy

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If you have a varied and balanced vegetarian, vegan or plant-based diet, you should have all the nutrients you and your baby need.

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Making the decision and knowing the challenges...

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Making the decision and knowing the challenges...

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Skip to main content

The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Research shows that breastfeeding provides many health benefits for you and your baby. But it also can be difficult to manage breastfeeding in today's hurried world. Learning all you can before you give birth can help. The decision to breastfeed is a personal one. As a new mom, you deserve support no matter how you decide to feed your baby.
Top questions about breastfeeding

All material contained on these pages are free of copyright restrictions and may be copied, reproduced, or duplicated without permission of the Office on Women's Health in the U.S. Department of Health and Human Services. Citation of the source is appreciated.

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Skip to main content The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site. The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

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Great resource: breaks down each trimester

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Great resource: breaks down each trimester

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The first stage of fetal development, called germinal stage, starts from ovulation around the 2nd week of gestation. Once fertilized, the egg begins multiplying as it travels to the uterus to implant itself in its wall. This triggers the pregnancy hormone, human chorionic gonadotropin (HCG), being secreted and showing up on a pregnancy test about two weeks later.

As the eggs grows, a fluid-filled amniotic sac starts to develop around it to cushion and protect it. A part of it will later become the placenta for nutrients and oxygen supply. For now, nutrients necessary for the rapidly growing embryo are provided through an attached small yolk sac.

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The first stage of fetal development, called germinal stage, starts from ovulation around the 2nd week of gestation. Once fertilized, the egg begins multiplying as it travels to the uterus to implant itself in its wall. This triggers the pregnancy hormone, human chorionic gonadotropin (HCG), being secreted and showing up on a pregnancy test about two weeks later.

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What to know about your First Trimester- get your facts here! 

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What to know about your First Trimester- get your facts here! 

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Fetal development is expressed in terms of gestational age, which is also counted from the first day of a woman's last period.

During the first trimester, the fertilized egg passes through three stages of fetal development. Starting right after conception and until week 4, the germinal stage consists of the fertilized egg moving down the fallopian tube to the uterus for implantation. By week 5, the embryonic stage begins with the egg (now called embryo) embedded and growing in the uterine wall. The third and the longest stage, called fetal, starts at week 10 and lasts until birth.

In the first month of pregnancy, the neural tube is formed. A few weeks later around week eight, baby's heartbeat can already be first detected. By the end of the first trimester, the main organs and limbs are developed, and the baby grows from being ¼ of an inch long to measuring 2.9 inches and weighing 0.8 ounces.

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Fetal development is expressed in terms of gestational age, which is also counted from the first day of a woman's last period. During the first trimester, the fertilized egg passes through three stages of fetal development. Starting right after conception and until week 4, the germinal stage consists of the fertilized egg moving down the fallopian tube to the uterus for implantation.

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What to know about your Second Trimester- get your facts here! 

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What to know about your Second Trimester- get your facts here! 

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After first trimester battles with morning sickness, fatigue, and other early pregnancy symptoms, most women begin their second trimester feeling significant relief. Many of the discomforts lessen or disappear, and mothers-to-be often feel more energetic.

Although usually less bothersome, there are still various important second trimester changes in the mother. The growing belly starts to show more and more as the second trimester weeks pass by, and with a decreasing risk of miscarriage, women are more eager to share the good news with friends and family.

While some experience the pregnancy glow and feel and look their best, others struggle with the mask of pregnancy, called melasma, which consists of reddish patches on the face. Frequent complaints also include body aches, stretch marks, or itching on the abdomen. Dental problems are also more likely to appear in the second trimester.

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After first trimester battles with morning sickness, fatigue, and other early pregnancy symptoms, most women begin their second trimester feeling significant relief. Many of the discomforts lessen or disappear, and mothers-to-be often feel more energetic. Although usually less bothersome, there are still various important second trimester changes in the mother.

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What to know about your Third Trimester- get your facts here! 

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What to know about your Third Trimester- get your facts here! 

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The third trimester of pregnancy is all about preparing for the delivery.Discover what to expect in the final third trimester weeks as you await your baby!