Diane, Author at Cherokee Women's Health

Pelvic organ prolapse (POP) refers to the sagging or drooping of any pelvic organs due to damage, trauma, childbirth or injury. The pelvic floor consists of a group of cradle-shaped muscles that hold pelvic organs in place. The pelvic organs include the uterus, bladder, cervix, vagina, rectum and intestines. Like any other part of the body, these muscles, with their surrounding tissues (fascia), can develop problems. If you fill a small plastic bag with grocery items, say for instance, a box of cereal, a few cans of vegetables, some jars and a package of rice —the bag should hold the items with no problem. But if you hang that full bag on a wall hook and leave it suspended, you’ll start to notice the items in it begin to bulge against the membrane of the bag as it takes on the shape of its contents. After a while, depending on how heavy the items are, the corner of the cereal box or rim of a can may start to bulge and even poke through as the bag stretches, weakens and eventually tears from the weight of the items in it. The groceries may even begin to protrude and dangle outside of the bag as the tears get larger. Pelvic prolapse happens much the same way. As the muscles and tissues holding the pelvic organs weaken, degrade or tear, the pelvic organs slip or drop through, sometimes forming a small hanging internal bulge. At other times, depending on the damage, they may actually dangle externally from the vagina or anus, causing problems and inhibiting their function. This is called prolapse. Who is at Risk for Pelvic Organ Prolapse? One in three women suffer from POP. Any activity that puts undue pressure on the abdomen can cause pelvic floor disorders. Typically, labor and childbirth are the leading causes of prolapse, especially when a woman has had several children, a long, difficult labor, or has given birth to a larger child.Pelvic organ prolapse becomes more common with age, usually around menopause when tissues damaged during a woman’s childbearing years begin to lose strength. Other causes are: What are the Symptoms of Pelvic Organ Prolapse? It is entirely possible not to have any symptoms at all. Sometimes pelvic organ prolapse is only discovered during a routine gynecological examination. Minor symptoms are a feeling of annoying pressure of the uterus or other pelvic organs against the vaginal wall, minimal malfunction of those organs, and mild discomfort. Other symptoms are: Symptoms may be aggravated by jumping, lifting or standing. Relief is usually found after lying down for a while. When Should You See Your Doctor? If you have increased sensations of pelvic pressure or pulling which is exacerbated by lifting or straining, but relieved when you lie down. Diagnosis At times, pelvic organ prolapse may be hard to diagnose, especially if a patient does not complain of any symptoms. Patients might be aware there’s a problem but cannot actually pinpoint its location. After asking questions regarding symptoms, medical history, past pregnancies, and other health problems, your doctor will perform a physical examination. Then, if organ prolapse is suspected or discovered, the following additional tests may be ordered: The doctor will then use a classification system to decide the organ prolapse level so he can best decide treatment options. Often, only simple non-invasive treatments and lifestyle changes are recommended for minor prolapse. If surgery is warranted, the following may be suggested: What Can You Do? Pelvic prolapse often sounds worse than it is. For many women, there are hardly any symptoms. For those who do suffer, there is help available, whether it is a simple lifestyle change, surgical repair, cosmetic enhancement or reconstruction. If you have questions about your gynecological health or would like to consult with one of our pelvic reconstructive surgeons, please call 770.720.7733 or schedule an appointment online.

Well Woman

First Gynecology Appointment

Diane /

At Cherokee Women’s Health, we understand the nerves a woman may experience when making a gynecology appointment, even for a routine annual examination. Our goal is to make patients feel as comfortable and assured as we can, beginning with their first appointment. To help prepare for an appointment, here are some expectations and answers to commonly asked questions about our practice and a routine gynecology examination. Health History Honesty is important when disclosing one’s health history. Doctors need to be aware of the past, so they can accurately care for a patient. Usual topics covered in a health history will include any medications currently being taken; sexual history; past pregnancies, surgeries, or treatments; and a familial history of cancer and other diseases. Come with Questions Don’t hesitate to bring up any concerns, no matter how trivial they may seem. It is best to be straightforward about symptoms, in the event that additional procedures need to be scheduled. Don’t leave our office with any questions unanswered! There is no need to be self-conscious about asking questions or discussing symptoms because our doctors have years of experience in their field. They discuss these topics daily with their patients. What to Expect A routine appointment lasts about an hour. Several exams take place during the appointment including a pelvic exam and a breast exam. Patients should also be prepared to provide a urine sample to test for pregnancy, and to catch any abnormalities in the sample that may indicate disorders or infections. A pelvic examination is performed to ensure that both external and internal areas of the vagina are normal, including a pap smear which is used to test for cervical cancer. At a patient’s request, a culture can be ordered to screen for any sexually transmitted diseases. The pelvic exam can make patients uncomfortable, but it is important to relax during the process. Reproductive health is important! A breast exam is completed to check for any lumps or irregularities in breast tissue. Based on family history of breast cancer, and your age, you may be referred for a mammogram which will screen for breast cancer. An opportunity to ask questions is part of the appointment. Be proactive and mention anything that is concerning. Honesty is essential to providing the best personalized care to our patients.

Labiaplasty Education, Vaginal Rejuvenation, Vaginal Rejuvenation Education

Clitoral Hood Reduction

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Clitoral hood reduction, also known as clitoral unhooding, clitoral hoodectomy, or clitoridotomy is a cosmetic surgical procedure which reduces the excess skin (prepuce) that covers the clitoris. The technique not only enhances the visual appearance of a woman’s pubic area, but it also serves to improve sexual pleasure by making the clitoris more accessible. As the name implies, the clitoral hood conceals the clitoris nestled inside, similar to an uncircumcised penis where the foreskin sheathes the head in its non-erect state. What is a Clitoris? Before launching into a description of the surgery itself, it may be of interest to understand the function, location, and description of the female clitoris. The clitoris is a woman’s primary and most complex erogenous zone. The head (glans) of this tiny body part is estimated to have more than eight thousand sensory nerve endings – twice as many as the glans of a penis. Though its sensitivity and size can differ from female to female, it normally resembles a pea or small pearl. When aroused by oral or manual stimulation, the clitoris becomes engorged much the same way the male penis does, thus enabling a woman to achieve orgasm. In order to more easily picture the location of the clitoris, simply imagine the nude frontal view of your pubic area. What you are looking at in your lower region is called the vulva. The cushioned ridge you feel beginning halfway down from your navel is the mons veneris. As you continue to move downwards, it separates into two cheek-like mounds that are separated by a vertical opening with lip-like tissue. Those lips are called the labia majora. Download your FREE Vaginal Rejuvenation eBook to learn more. By gently pulling apart the labia majora, you will expose two more inner lip-like flaps of tissue on the left and right. These are labia minora. At the base of the labia minora, leading up to the anal opening, there is a small bony ridge called a perineum. At the upper tip of the labia minora, that small tube-like protrusion is the clitoral hood. Peeking out through, or hiding inside the opening of that hood is the tip of the clitoris. The entire clitoris itself is about 4 inches long, but, as explained earlier, the head – or glans, is small, roughly the size of an eraser on the end of a pencil, and it is extremely sensitive to touch. Why Would a Woman Need a Clitoral Hood Reduction? Because the size, shape and thickness of the clitoral hood differs from woman to woman, this procedure is not always done for medical reasons alone. It can also be done for aesthetic purposes to give the vulva a neater, trimmer look. In some cases, the clitoral hood may be extremely large, inhibiting access to the clitoris, thereby preventing the achievement of sexual gratification. A thick or large hood may also cause friction against clothing which can lead to soreness, redness or inflammation. Often, a woman with an enlarged hood may also have large labial lips that protrude in a manner she may find unsightly. Both the clitoral hood and the labia, if quite prominent, can sometimes create obvious bulges that can be seen outlined against close-fitting outerwear. Women may opt to cosmetically correct prominent labia through a procedure called labiaplasty at the same time as they undergo a clitoral hood reduction. What Can Be Expected During and After the Procedure? Clitoral hood reduction surgery is normally done as an outpatient procedure under local or general anesthesia. A specialized laser and surgical instruments remove a predetermined amount of superfluous hood tissue, insuring that accessibility and stimulation to the clitoris is no longer restricted. The clitoral head is not modified in any way. Only the hood is altered. At this time, if the patient so chooses, the surgeon may perform additional procedures to the genitalia, such as vaginal tightening, hymenoplasty or vaginoplasty. Clitoral hood reduction is microsurgery. The procedure, after complete healing, will leave no scars. Tiny, barely visible incisions will be concealed in the folds of tissue around the surgical area. There will be some numbness experienced after surgery, but this will subside. The numbness is in no way indicative of nerve or any other damage. In fact, after the effect wears off, sensitivity to the clitoris will be heightened due to easier access to it. The entire procedure will take approximately an hour depending on what needs to be done. Aftercare and Recovery The area will be tender and inflamed, but rest and application of ice will help, along with over-the-counter pain relievers. After about two or three days, the patient will be able to return to work. Recovery times vary depending on the extent of the surgery. The patient will be cautioned not to engage in sexual intercourse during that time in order to avoid complications. Strenuous activities such as horseback or bicycle riding, running, and heavy lifting should also be avoided during this time. Special care to keep the area clean is important in order to avoid any possibility of infection. What Are the Complications? Complications are rare. However, your doctor should be contacted if there are any of the following problems: Facts Regarding the Clitoris The size and shape of the full clitoris was not revealed until 1998. Until that time, even though physicians knew of its existence, it was either eliminated from anatomy publications that previously mentioned it briefly, or it was ignored altogether. A 3D sonography image was not available until 2009. Throughout history, the importance of the clitoris to a woman’s sexual pleasure has either been disputed or dismissed altogether. In fact, in the 1500’s, the presence of the clitoris in women was used as irrefutable proof of witchcraft, and was referred to as the ‘devil’s teat’. Perhaps the clitoris snuggled deep within the camouflage of a thick clitoral hood back then saved many a woman from imminent death. Cherokee Women’s Health Can Help Genital surgery or any type of vaginal rejuvenation

Healthy Pregnancy Diet: What Not to Eat When You’re Expecting

Diane /

Nutrition is an important part of pregnancy. It gives moms the opportunity to increase their intake of vitamins, minerals, and essential nutrients. This boosts their energy, helps their babies’ development, and can even improve some of the symptoms of pregnancy. But as important as what to eat when pregnant is a topic that’s decidedly less fun: what not to eat during pregnancy. Dr. Haley Discusses Nutrition During Pregnancy Foods to Avoid During Pregnancy Cherokee Women’s Health helps expectant mothers in Canton through the unique experience of pregnancy. For a personalized diet plan, advice on healthy eating and fitness during pregnancy, and other prenatal care, schedule an appointment with one of our certified physicians or midwives.

Anterior and Posterior Repair Education, Mesh Education, Pelvic Organ Prolapse Education, Urogynecology

What is Prolapsed Bladder?

Diane /

Prolapsed bladder, also known as fallen bladder or cystocele, is a condition where the bladder drops down from lack of support. A concave dome-shaped group of pelvic floor muscles and tissues hold the bladder and other organs in place. Due to a variety of reasons, these muscles and tissues can weaken over time. This causes the bladder to descend from its fixed position and slip downwards into the vagina, much like a big toe begins to rub, then protrude through an old, worn sock. In more severe cases, the bladder may dangle completely outside of the vagina. What Causes Prolapsed Bladder? What are the Symptoms? In cases where the bladder prolapse is mild, women may not experience any symptoms at all, and the condition may only be discovered during a routine examination. When Should You See Your Doctor? If you notice that you may have any of these symptoms and suspect a prolapsed bladder, you should see your doctor immediately. This condition often means that other pelvic organs may also be prolapsed, as the same muscles and tissues hold the uterus, cervix, vagina, rectum, and intestines in place as well. This is not a condition that repairs itself. It usually worsens over time, but it can be fixed thanks to many modern methods available today. Diagnosis and Tests In obvious cases, an examination of the pelvis and genitalia can visually confirm prolapsed bladder. If less evident, the doctor may use something called a Voiding Cystourethrogram to confirm diagnosis. This is a sequence of x-rays taken while the patient is urinating so that the physician can see the bladder shape and what may be causing flow problems. He may also request additional x-rays of different abdominal sections to eliminate other theories, after which he may test muscles, nerves and the force of the urine stream to conclude his diagnosis and recommend treatment. Additional tests, if necessary are: Treatment If tests confirm prolapsed bladder, your doctor will categorize its degree as mild, moderate, severe or complete. If it is mild, it usually requires no immediate treatment other than to refrain from heavy lifting or exertion.For more serious cases, depending on health, age and other factors, some non-surgical treatments include: Surgery Should you need surgery, one of the following may be recommended: Types of Reconstructive Surgery What Can You Do? Make an Appointment Today Prolapsed bladder and its effects can be uncomfortable, restrictive and inhibit a normal lifestyle. Our board-certified OB/GYNs can address these issues so you can get back to living the life you deserve. Call and make an appointment today at 770.720.7733 or schedule an appointment online.

The 411 on Vaccines and Pregnancy

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A mother’s body is more than just a home as her baby grows: it is protection, sustenance, and strength. When a mother eats well, exercises, and takes care of her body, she is also helping her baby grow healthy and strong. Vaccines can help both mother and baby stay healthy during pregnancy and the early postpartum months. But not all immunizations are safe for pregnant women. If you’re trying to expand your family, here’s everything you need to know about vaccines during pregnancy. Pre-Pregnancy Vaccines If you’re trying to become pregnant, you likely have a list of things to eat, avoid, measure, and track. Moms-to-(Hopefully)-Be can add “vaccinations” to the list. Vaccines that contain traces of live viruses aren’t safe for pregnant women. Get these immunizations at least one month before trying to become pregnant. To prevent illness and infection during pregnancy (for both yourself and your baby), make sure you’re up-to-date on these vaccines. MMR (Measles, Mumps, and Rubella vaccine) Chickenpox vaccine Safe Vaccines During Pregnancy According to the CDC, some vaccines are safe for pregnant or breastfeeding mothers. The flu shot is recommended for pregnant women during flu season (November-March). The flu shot, which is made of dead strains of the virus, is safe for both mother and child. Vaccines that contain live viruses, such as some flu nasal sprays, are not safe during pregnancy. The TDAP vaccine, which protects against whooping cough, is made with toxoids (bacterial proteins which have been chemically altered), and is also safe for pregnant women. Other low-risk vaccines, such as the Pneumococcal vaccine and Hepatitis B vaccine, may be recommended by your physician based on your individual risk of contracting the disease. Post-Pregnancy Vaccines If you weren’t able to get up-to-date before welcoming your bundle of joy aboard, the postnatal period is the time to get caught up on your adult vaccinations. Parents should get immunized to protect their infants while they’re still too young for some vaccinations. Breastfeeding mothers can follow a normal adult vaccination schedule. For more information about which vaccines are safe during pregnancy, call Cherokee Women’s Health.

GYN Problems

Fecal Incontinence

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Fecal incontinence is a condition where one lacks the ability to control bowel movements. In some cases, even the sensation associated with the need to move one’s bowels is not felt. In these cases, stool or mucus may be impossible to hold back and can oftentimes result in mortifying accidents. Normally, strong healthy muscles and nerves in the anus and rectum cooperate with each other, working together to keep stool in the rectum where it belongs until it’s time to have a bowel movement. This works much the same way as a garden hose with a fitting attached to a spray nozzle. When the tap is turned on, the water remains contained in the hose until the trigger of the nozzle is squeezed, releasing water spray. If the nozzle or fitting is faulty, depending on the extent of the damage, water will either dribble out slowly or gush uncontrollably. Fecal incontinence is similar. There is either some uncontrolled leakage or full incontinence. Fecal incontinence can be occasional or chronic. Most of us suffer from gastric issues from time to time and can experience some loss of bowel control. But sometimes, what we presume will be simple flatulence may result in an unwelcome surprise of anal leakage. Urge bowel incontinence is the need to defecate without warning. Those who have it know they need to get to a toilet, but usually cannot get there in time. Passive incontinence is being completely unaware of the need to defecate. The sensation is simply not there, and stool is passed with no warning. Because of humiliating factors such as sound, odor and visible staining associated with this condition, it can often draw unwanted attention. In time, psychological issues like humiliation, depression, shame and even self-disgust may arise, causing those afflicted to withdraw and isolate themselves from society. Who is Affected? Fecal incontinence affects one in 12 adults in the United States alone. There is no age limit, however it affects older adults more often, and slightly more women than men. To put this ratio into perspective, at least one person at every family reunion or five people at any moderate church gathering may be suffering from fecal incontinence. It’s not uncommon. What Causes Fecal Incontinence? Inactivity: Bed or wheelchair bound individuals, the elderly who lead a less vigorous lifestyle and those who spend most of their day in a sitting or prone position are more susceptible. A sedate lifestyle is more likely to cause stool retention in the rectum. Softer or more liquid fecal matter can leak past the harder stool causing fecal incontinence. Constipation: Hard, thick stool can develop with constipation, stretching the rectum and relaxing sphincter muscles. More watery fecal matter forms behind this stool and may leak out. Subsequent straining to relieve constipation may weaken pelvic floor muscles. Diarrhea: We’ve all had it at one time or another and know how hard it is to get to a bathroom in time. Accidents often result because watery fecal matter is harder to hold in than firmer stool and fills the rectum faster. Loss of Rectal Elasticity: The rectum stretches to allow room for fecal waste, however scarring, sores and irritation caused by such things as radiation, inflammatory bowel disease and rectal surgery may cause the rectum to stiffen and no longer expand. Childbirth via Vaginal Delivery: Giving birth vaginally, especially if forceps are used, can cause damage to nerves and muscles in the pelvic floor. So can surgically cutting (episiotomy) in an effort to minimize vaginal tearing during birth. Fecal incontinence may occur years later or immediately after giving birth. Hemorrhoids: Hemorrhoids that develop around the anus may prevent sphincter muscles from closing completely. Since this muscle keeps feces in the rectum, any small portal can allow leakage to escape. Rectal prolapse: Sometimes the rectum can descend through the anus, causing the sphincter to not do its job properly. Rectocele: The rectum and vagina are separated by a thin layer of muscle. If that layer weakens, the rectum may jut down into the vagina forming bulges. In more severe cases, it can visibly hang outside the vagina, resulting in possible retention of stool in the rectum. It is speculated, though not certain, that this may cause fecal incontinence. Diet: Certain drinks such as dairy products or caffeine beverages may have a laxative effect, aggravating fecal incontinence symptoms, as can spicy, greasy foods. Overuse of Laxatives: Sometimes mother nature may need a little medicinal nudge, but chronic use of laxatives poses a higher risk for developing fecal incontinence. Muscle Weakness or Damage: Circular muscles called sphincters located in the rectum contract tightly to prevent feces from passing through the anus (similar to the concept of aperture on a camera). These muscles can be damaged or weaken with age, losing strength and tautness. Nerve Damage: Impairment of the nerves in the sphincter muscles, and those that sense the need to pass stool can also result in leakage. Damage to both the sphincters and nerves can be caused by childbirth, cancer or hemorrhoid surgery. Additionally, nerves may be damaged due to stroke, constant forcing of stool, head trauma, injury to the spinal cord and diseases that affect nerve function such as multiple sclerosis and diabetes. How is Fecal Incontinence Diagnosed? After questions are asked, symptoms charted and a physical examination is completed, your doctor may order a series of tests to correctly diagnose fecal incontinence. These tests may include: Anal Ultrasound: This test specifically pinpoints the anus and rectum. Sound waves form an image of the sphincter muscles. Anal Manometry: An inflated balloon and pressure sensors check rectal sensitivity and function, along with sphincter muscle tightness. Magnetic Resonance Imaging (MRI): Magnets and radio waves produce images of soft internal issues and organs. Anal Electromyography (Anal EMG): This checks the health and electrical activity of the pelvic floor nerves and muscles, translating those into images and sounds. Defecography: An x-ray of the area surrounding the anus and rectum indicates the patient’s ability to hold and

Well Woman

Vaginal Discharge – Should You Be Worried?

Diane /

What is Vaginal Discharge and What Causes It? The vagina is similar to a corridor that leads from outside of woman’s body to her inner reproductive organs. The vagina and cervix contain tiny internal glands that create and secrete fluids. The purpose of these fluids is to wash away bacteria and dead cells. This natural cleansing process protects the vagina, and prevents infection, much the same way a kitchen sieve holds strawberries while a good rinsing flushes away harmful dirt, grit and anything else those berries might have been lying in as they grew. While vaginal discharge can be annoying, often staining and occasionally ruining those favorite, overpriced panties, it is a perfectly natural bodily function and should not be tampered with unless problems arise. If something interferes with the delicate balance of vaginal secretions, uncomfortable, painful and even serious infection may occur. What is Normal, Healthy Vaginal Discharge? Color: The color of healthy vaginal discharge can range from clear to milky white, the latter usually occurring during ovulation. It may also be clear with white stringy flecks. When dry, white discharge may turn yellow on underclothing.A bloody discharge is also perfectly normal during a woman’s period and is no cause for alarm. At times, droplets of blood can be mingled in with discharge between menstrual periods and this is known as spotting. Unless excessive, or accompanied by discomfort, this is also normal. Amount: The amount can vary anywhere from 20 mg to 60mg a day (yes, it feels like much more!) This can increase to about 600mg during ovulation. Increase in discharge can also occur during exercise, breastfeeding, contraceptive use, sexual arousal and even emotional stress. Vaginal discharge decreases at menopause due to lower estrogen levels. Consistency: The texture of normal discharge also fluctuates. During ovulation, it can be thin and watery. This texture is Nature’s way of enabling sperm to pass into the uterus allowing a better chance of fertilization. At other times, it is thicker, more acidic, and less hospitable towards sperm. This is temporary, just like a mild marital spat. Discharge texture varies depending on the body’s levels of the hormones estrogen and progesterone, both found in birth control pills. This is why women who take oral contraceptives produce thicker discharge, thus preventing unwanted pregnancy. During pregnancy, a thick mucus plug (operculum) forms inside the cervical canal. Containing antibacterial properties, its function is similar to that of a cork or safety seal for the uterus, protecting it from uterine fluid leakage or pathogen invasion. When dilation begins to occur before childbirth, the plug loosens and drops out, resembling discharge tinged with blood. Odor: Discharge odor can vary depending on medication, menstrual cycle, diet, activity, personal hygiene, pregnancy, lubricants, and hygienic cleansing products, but usually a slight musky, though not unpleasant odor is normal. Receiving oral sex can sometimes produce a different odor. When Should You See Your Doctor? Although vaginal discharge is vital in maintaining optimal health of the reproductive organs, the delicate Ph balance can sometimes be compromised leading to infection. Infections may occur at any time, but are more likely to happen when the Ph balance is less acidic, right before or during menstruation. If you experience any of the following symptoms, see your doctor. These can possibly be indications of infections or sexually transmitted diseases such as Bacterial Vaginosis, Yeast Infection(Candida), Pelvic Inflammatory Disease, Human Papillomavirus, Trichomoniasis, Gonorrhea, or Chlamydia –to name a few: • Pain or inflammation accompanying discharge• Redness in vulvar or vaginal areas• Strong unpleasant smelling discharge immediately after intercourse• Burning or itching• Rash• Burning while urinating• A cottage cheese like texture.• Thick, lumpy, or pasty discharge• Foul smelling green, yellow, grey, or cloudy discharge• Excessive or recurring brown or bloody discharge, especially when not on your menstrual cycle• Strong, foul, fishy odor• Watery discharge• Any unusual discharge accompanied by abdominal pain, uncommon fatigue, fever, sudden weight loss, and increased urination.• Blisters or sores in the vaginal or vulvar area.• Painful intercourse Treatment After a brief medical examination which is usually enough to identify the problem, your doctor may request additional tests to analyze skin, cervical or discharge samples.When the problem is identified, most vaginal discharge abnormalities can be treated with prescription medications such as antibiotics, creams, antifungals, or suppositories. These should always be taken for the full amount of time prescribed by your doctor, no matter how much better you feel.In some cases, it may be necessary to treat both the patient and her sexual partner, and both may be asked to refrain from sexual intercourse until treatment is successfully completed.If symptoms persist after medication is completed, a follow up visit may be necessary.Over the counter medications are available for common yeast infections, but should be avoided if pregnant unless approved by a physician.Abnormal discharge may be indicative of some cancers, but this is rare. How You Can Help Prevent Problems • Use condoms, especially with new sexual partners.• Have an annual pap smear to screen for possible cancer. It’s only uncomfortable for a minute• Keep the genital area dry and clean with regular bathing, showering and gentle wiping from front to back after urination or defecation.• Avoid harsh soaps, feminine sprays, powders, chemicals or douches around the vaginal area. They can may upset the Ph balance and kill important bacteria. Being field flower fresh can sometimes do more harm than good• Avoid deodorized pads and tampons, especially those discount store brands that can be smelled before you enter a room.• Wear absorbent cotton underwear, and save the sexy, synthetic ones for special occasions unless they have a cotton crotch piece.• Be vigilant when you wear tampons. Anyone can forget, especially near the end of a period when there is little or no blood. It happens more often that women think.• Use products designed specifically for vaginal lubrication. Avoid petroleum jelly or other household lubricants your grandmother suggested.• Eat a healthy, well balanced diet and drink plenty of fluids. Yogurt containing live cultures helps to prevent yeast infections.•

Babies and Bladders

Diane /

Every expectant mother has heard jokes about pregnant women running to the bathroom all the time. Overactive bladder is one of the most common symptoms of pregnancy in the first trimester, and it only gets worse as your pregnancy develops. But for some, overactive bladder causes an even more embarrassing symptom: pregnancy incontinence. What to Know about Pregnancy Incontinence Pregnancy incontinence, or bladder leakage, gets less press than overactive bladder syndrome (possibly because fewer dads-to-be find it a funny road trip joke), but many pregnant women suffer it. Bladder leakage most frequently occurs when coughing, laughing, sneezing, or straining, but it can happen almost anytime. The good news is that pregnancy incontinence is usually temporary. When your hormone levels go back to normal and your body heals, your bladder should return to normal too. How to Treat Pregnancy Incontinence Before trying home remedies, make sure you’re leaking urine. If the liquid is clear and odorless, it may be amniotic fluid. It’s rare, but if you are leaking amniotic fluid, contact your obstetrician immediately. Okay, you sure it’s urine? Here’s what you can do to treat pregnancy incontinence. Call Us Today Pregnancy incontinence may be frustrating, but it’s a normal part of pregnancy. If your incontinence lasts up to six weeks postpartum, speak to your physician about treating incontinence before it becomes a long-term issue. For more information on pregnancy incontinence, call us at 770.720.7733 or schedule an appointment online.

Why Is Breastfeeding So Hard?

Diane /

Breastfeeding is probably the first most intimate bond a mother will ever create with her child, but sometimes it can take a little while to get it right—both for mother and baby. Much like picking up rice with chopsticks for the very first time, breastfeeding requires patience, practice, time and effort. Although babies are born with a natural instinct to suckle, and mothers usually produce the colostrum and milk they need immediately, sometimes getting the two natural occurrences to cooperate with each other can be difficult. Apart from the time and discomfort needed to recover from childbirth, baby’s constant demands for food, cuddling, changing– not to mention possible colic- the first few days can be overwhelming on a new parent. Lack of sleep can also cause impatience, which in turn is something a baby can easily sense. No matter how many decibels you attempt to lower your voice after drowsily walking into walls during that three o’clock feeding, your baby will still pick up on your irritability and react accordingly with fussing, flailing or crying. Compounding all this with a difficulty to breastfeed could easily leave the mother experiencing feelings of failure, shame and anxiety. Rapid hormonal changes on her part add to the melting pot of emotional stew. Latching Problems Breastfeeding can be a painful, uncomfortable experience during the first few postpartum weeks. Although hungry newborns may not have teeth, their gums can certainly clamp on well enough to make a new mother wince, even yelp at times. Until tender, engorged nipples become accustomed to the sensation, it can be highly unpleasant for the first little while. If pain persists after this adjustment period, however, it may possibly be caused by a bad latch. A bad latch may occur for a number of reasons, such as cradling the baby’s head at an improper angle, positioning your breast incorrectly, flat or inverted nipples, or an infant who hasn’t quite yet grasped the intricacies of sucking and getting tasty results. Learning to latch may take time. If you look down and see that your areole or nipple are visible, your baby may not be latching correctly. Both serve a purpose similar to a bull’s eye on a target. Baby needs to zone in and clamp on the center to achieve proper suction. The sensation of the nipple, and in some cases the tiny bumps surrounding it on the areole serve as a type of braille to baby’s sensitive mouth. Nursing pillows may facilitate finding the correct angle, thus gently coaxing your child to a better position. If you can’t resolve the latching problems on your own, there is no need to get frustrated or to feel badly about it. At your next appointment, ask your obstetrician or certified nurse-midwife for information on overcoming breastfeeding problems. They are familiar with the problem and will gladly help to make breastfeeding a more enjoyable nurturing time for you and your infant. Inverted or Flat Nipples 1 to 3% of all women have flat or inverted nipples which can create a challenge when breastfeeding. Speak to your obstetrician about breastfeeding with inverted nipples. Some methods he or she may recommend would be to pump before breastfeeding to stimulate milk flow, or using a silicone shield to help your baby latch. Some women with flat or inverted nipples may require the help of their spouses to get a good latch going. In a way, this can also be a pleasant bonding time for their partners. Breast milk provides babies with vital nutrients to help them grow and develop into healthy, strong little people. It is recommended that mothers try as much as possible to introduce their infants to not only this beneficial form of nourishment, but the resulting closeness and warmth both mother and baby can derive from it. For more information on lactation, Northside Hospital-Cherokee has a center dedicated to lactation and their website offers lots of great tips.

Common Breastfeeding Problems

Diane /

Common Breastfeeding Problems Apart from providing valuable colostrum and vital nutrition for babies, breastfeeding can create an intimate bond between a mother and newborn. Another plus is that breastfeeding requires more calories than pregnancy, Mother Nature’s way of rewarding a new mother by giving her a jump start on the road to ‘baby weight” loss. At first, however, to the dismay of many new parents, it isn’t always the warm fuzzy experience they imagined it would be. Breastfeeding does not always happen naturally. The milk is in the mother’s breast, and the baby instinctively makes sucking motions looking for food, but the act of successful breastfeeding itself is a skill that requires a little practice on both parts. Motherhood can be challenging and intimidating enough, especially for first time moms who want to do the very best job possible. Even the sweetest, undemanding baby can be intimidating due to lack of experience, let alone a colicky fussy child. Encountering breastfeeding problems can raise stress and anxiety levels at the very best of times, and this frustration may result in abandoning breastfeeding altogether. Most breastfeeding difficulties, however, are easily remedied with minor position adjustments or a few timeless suggestions from your OB-GYN. Solving Common Breastfeeding Problems Low milk production. Many moms underestimate their milk levels, especially when first learning to breastfeed. But a few tricks can increase your supply: ensure your baby latches well and drains both breasts at each feeding, drink plenty of water, use a breast pump between feedings, and nurse at night when milk production hormones surge. You can also ask your doctor to modify your diet to include foods that encourage healthy milk production. Latching pain. Latching pain is expected for new moms, but it shouldn’t last. If latching pain lasts longer than a minute, reposition your baby to an asymmetrical latch, where his mouth covers the nipple and the lower part of the areola. Cracked nipples. A common result of latching problems, improper pumping, or thrush, cracked or bloody nipples can cause serious anxiety in new moms. But a little blood won’t harm the baby, and the solution is simple: lanolin cream. Other remedies include repositioning your baby’s latch, breastfeeding more frequently for shorter intervals, and letting some milk air dry on your nipples. Thrush. A yeast infection that may develop in infants’ mouths, thrush can spread to the breasts, causing itching, soreness, and sometimes a rash. See your doctor, who will provide an antifungal cream to be applied to both your nipple and the baby’s mouth. Every woman faces her own challenges during pregnancy and postpartum. We encourage our patients to take advantage of the rich resources in our health community, including the Lactation Program at Northside Hospital-Cherokee, where we deliver all our moms. If you have concerns about breastfeeding, schedule an appointment with us today.

Healthy Weight Gain During Pregnancy

Diane /

Every woman gains weight during pregnancy. For some, this is a positive experience: the healthy glow and rounded figure are a badge of honor, broadcasting her good news to the world. For others, it’s a struggle: dealing with the stress of weight fluctuation on top of the other body changes pregnancy brings. But all moms share the same question: how much pregnancy weight gain is too much? Healthy Weight Gain During Pregnancy The amount of weight gained during pregnancy isn’t an abstract question. It can affect the health of both mother and child during gestation. Gaining too much weight contributes to postpartum weight retention, but gaining too little leads to inadequate birth weight of your infant. If you’re worried about weight gain, discuss it with your obstetrician or CNM. Your physician can give you an individual assessment to make sure you gain a healthy amount of weight during pregnancy. To get you started, here’s a handy chart from the American Congress of Obstetricians and Gynecologists. For underweight mothers (BMI of 18.5 or less), the recommended gain is 28-40 lb For average weight women (18.5-24.9 BMI), there’s a recommended weight gain of 25-35 lb For overweight (25-29.9 BMI) moms, doctors recommend a 15-25 lb weight gain For obese mothers (30 BMI and higher), the recommended weight gain is 11-20 lb How to Control Weight During Pregnancy If you’re gaining too much or too little weight during pregnancy, ask your obstetrician about a personalized nutrition plan. Not only will a proper diet improve your weight gain, it will also provide necessary nutrients to you and your baby. Moms-to-be can also begin a pregnancy exercise routine to improve health and decrease the discomforts of pregnancy. Some conditions make exercising during pregnancy unsafe, so always speak to your doctor before starting a new fitness regimen. Want to learn more about nutrition, fitness, and healthy weight gain during pregnancy? Visit Northside Hospital-Cherokee or make an appointment with one of our physicians or advanced practice providers today at 770-720-7733.

Author name: Diane

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