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What to Expect: The First Trimester

Congratulations, you’re pregnant! If you’re already a parent, you know what to expect, but if this is your first child, pregnancy can be a mysterious, sometimes almost frightening process. Today’s pregnancy tests are so precise, that they can detect the presence of human chorionic gonadotropin (Hcg) levels within days following fertilization. Immediately after a fertilized eggs attaches to the woman’s uterine wall, her body produces this hormone. A pregnancy strip can confirm conception has taken place by identifying Hcg presence in only a few drops of urine. What Happens Next? The average pregnancy lasts 280 days or 40 weeks, calculated from the first day of the woman’s last menstrual period. The first trimester covers week 1 to 12. As soon as the fertilized egg (zygote) latches on to the uterine wall, both the umbilical cord and placenta begin to form. Hormonal changes rapidly begin taking place in your body. Often, early symptoms of pregnancy are mistaken for PMS. These symptoms and others include: Spotting or bleeding Fatigue Dizziness (and possibly even fainting) Aversion to certain foods Queasiness or nausea Headache Cramps Bloating Moodiness Backache Breast tenderness More frequent urination (micturition). Can Anything be Done to Counteract These Symptoms? When the egg implants itself into the uterine wall, spotting may occur, but it’s always wise to report any bleeding to your doctor to rule out the possibility of miscarriage, ectopic pregnancy or infection. Additional progesterone can elevate blood pressure, dilate vessels, overheat the body, and force the heart to beat faster when sending blood to the uterus. All these changes can bring about fatigue, moodiness, dizziness and possible fainting. Progesterone can also slow some body functions down, including digestion which causes nausea, vomiting, constipation, and indigestion. The body reacts by trying to purge what is upsetting it, resulting in morning sickness. Higher Hcg in the body, especially in a multiple pregnancy, can also trigger nausea. It’s best to avoid foods that repel you during this stage. For intolerable nausea or vomiting, inquire about supplements or devices that can ease discomfort. If you experience dizziness, move slowly, especially when you get up from sitting or lying down. Should faintness occur, sit down with your head between your knees. Rest when possible. Moderate headaches may be relieved with acetaminophen, but never without consulting your physician. If symptoms are excessive, speak to your doctor. Cramps, bloating and backache can also be attributed to hormonal fluctuations. Frequent urination, even in this early stage, is usually the result of uterine growth and pressure against the bladder. Fluid intake should not be limited, as this is a normal occurrence. Breast tenderness is also hormonal. The breasts are preparing themselves for the baby’s upcoming nutritional needs. Investing in a good support bra may help. What precautions can I take during this time? Don’t smoke, and avoid exposure to second hand smoke. Don’t drink alcohol or use recreational drugs. Mention any prescription drugs you use to your doctor. Avoid caffeine Disclose any work hazards to your obstetrician, such as exposure to harmful chemicals, radiation, dangerous metals, toxic waste, etc. Do not eat or handle raw meat. Wash all fruits and vegetables thoroughly. Wear gloves while handling soil. If you own a cat, have someone else change the litter, and wash hands diligently after animal contact to avoid risk of toxoplasmosis which can harm your baby. Discuss your diet with your doctor and make necessary recommended changes. Take any vitamins, supplements and minerals your doctor prescribes regularly. Is it Safe to Engage in Sex During the First Trimester? Unless you have a specific medical condition of concern, it is safe to have sex. How Big is My Baby in the First Trimester? Between week four and twelve, your baby grows from the size of a tiny fig seed to roughly the length of that credit card you’re probably beginning to max out in happy anticipation. He or she is almost 3 inches long, weighing approximately one ounce and is about the size of a golf ball. Yet, by now, those tiny fingers have fingerprints. Organs are formed, functioning, and are visible through almost transparent skin. A heartbeat can be detected. The body is beginning to catch up with the head that still accounts for one third of body size. Reflexes are becoming sharper. The fetus can make sucking motions and respond to stimuli such as prodding. Eyes are close together on the face instead on either side of the head. Ears are forming and almost in position. The skeleton is made of cartilage that will gradually become bone. Gender is discernable. What Tests Are Performed During the First Trimester? Your blood will be will screened for type, count, RH factor, anemia, German measles (rubella), hepatitis B, HIV and other sexually transmitted diseases, along with exposure to diseases such as toxoplasmosis and varicella. Other test will look for genetic problems such as sickle cell anemia, Tay- Sachs disease, cystic fibrosis, etc. A combination blood/ultrasound nuchal translucency for Down syndrome and other chromosomal abnormalities may be offered during the latter part of this trimester. Glucose levels will be analyzed for signs of diabetes and urine checked for albumin which may indicate preeclampsia An ultrasound, usually near the end of the first trimester, will determine a due date, gender, and normal fetal progress. Although your baby develops throughout your entire pregnancy, extra precaution during the first trimester when fetus growth is so accelerated is vital. Our doctors can guide you in all the ways possible to ensure both your health and that of your child. For more information, visit Northside Hospital Cherokee. For an appointment, call our clinic at 770.720.7733.

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Why Is Breastfeeding So Hard?

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.

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