Hiccups can be a big worry for many pregnant women and new moms. Why does their baby have them? Is their baby in pain from them? What can they do about them? Rest assured, most of the time the baby is not in pain, and the mother is more bothered by the fact that the hiccups have appeared, than the baby is having them.

Hiccups in Utero
Pregnant women often mention feeling their baby having hiccups while in the womb and wonder what causes this. These hiccups can start in the first trimester, but won’t be felt by mom until late in the second trimester or during the third trimester. Rarely do the hiccups bother the mother-to-be, however some moms might worry that it is hurting their baby.

The exact cause of your baby’s hiccups is unknown. However, many specialists believe that your baby’s hiccups may be helping to strengthen the diaphragm muscle in order to help the baby breathe both in the womb and once they are born. In many cases your baby will have the hiccups at the same time everyday.

Not only can hiccups be felt by the mom-to-be, but it can also be detected during an ultrasound and picked up on a Doppler while at the doctor’s office for a routine visit. After a woman has been assured that these hiccups are normal and are not bothering their baby, then they become something that can be looked forward to on a daily basis, much like their baby kicking.

Hiccups After Birth
If your baby had hiccups while in utero, it is very plausible that he will have the hiccups after he is born. Some babies that did not have them in utero may still have them after birth. Hiccups can start after birth as early as the day your baby is born. Like the hiccups your baby might have had in utero, these hiccups are generally not painful for your baby.

Hiccups after birth occur when the diaphragm muscle contracts causing your baby to take quick short breaths. Normally these hiccups go away after only a few minutes. If they are really bothering you, try burping your baby more often during feedings. To get them to stop you can try to feed your baby whether you are nursing or bottlefeeding. The constant sucking and swallowing can help that muscle relax and help the hiccups stop.

by Elizabeth Pantley, Author of Perfect Parenting and Kid Cooperation

Question
What are the signs of thrush? If we have it, how do we get rid of it?

Learn about it
Thrush (Candida albicans) is a common yeast infection that occurs in a baby’s mouth and diaper area, and on a nursing mother’s nipples. It is almost always harmless, but because it thrives in these warm, moist places, it is extremely stubborn and difficult to eliminate. In addition, it can be very annoying because it is quickly and easily transferred back and forth from mother to baby, until both are totally clear of it.

The signs of thrush in the baby
You baby may have all of these signs, some of them, or even none. If you suspect thrush, review both the signs for a baby and the symptoms that you have. The following are typical signs of thrush in a baby:

• White or gray spots or patches on the inside of your baby’s mouth, gums, or on his tongue. (A milk coating on the tongue wipes off easily; thrush does not.)
• An opalescent shine on your baby’s lips or inside his mouth.
• Red face, particularly on the cheeks.
• Persistent diaper rash that doesn’t respond well to usual remedies.
• Fussiness that appears worse during or after feeding.
• Bleeding of the mouth or gums in severe cases.

Signs of thrush in the mother
The following are typical signs of thrush, but many of these can signal other problems as well. If you review the list for yourself and that for your baby, and suspect thrush is the problem, call your healthcare provider, lactation consultant, or La Leche League leader.

• Pain in the nipples or breasts during or after feedings that may persist between feedings
• Deep pink, red or purple discoloration of the nipple and areola
• A shiny glow on the areola
• Dry, peeling nipples
• Rash or white spots on the nipples
• Itching or soreness that indicates a vaginal yeast infection

Note: You are particularly susceptible to thrush infection following the use of antibiotics, as these medications kill off not just “bad” bacteria, but the “good” types that keep candida under control.

Treating the family
If you suspect a thrush infection, both you and your baby will need treatment simultaneously until all signs of thrush are gone. If you are also nursing an older child, you will have to treat her, too. In some cases, your partner or other members of the family may shows signs of thrush (athlete’s foot, severe dandruff, jock itch, vaginal yeast infection) that will have to be treated to prevent the recurrence of thrush in the family.

Treating the baby
Many babies with thrush show little response to the yeast infection. For others, it is painful and prevents proper nursing. In that case, the infection should be treated promptly and aggressively so that your baby’s growth is not compromised. It’s important that you talk to your baby’s doctor, who may prescribe a topical medication that can be applied directly to your baby’s mouth for pain relief and to clear up the infection. The most common medication is a prescription anti-fungal cream. A homeopathic doctor can talk with you about using a tincture made of usnea lichen, mugwort, rosemary, or unsweetened yogurt with active cultures.

An alternative treatment is 1% gentian violet solution, painted with clean cotton swabs onto affected areas once a day prior to breastfeeding. These areas include your baby’s mouth as well as your nipples and areolae. It’s very messy and will turn your baby’s lips and your nipples purple for a few days, but it is often very effective. (Watch your baby’s mouth carefully for any signs of negative reaction, such as sores, from the treatment. Too much of the solution can burn the skin’s surface. If anything seems amiss, or if no relief occurs within four days, stop treatment and visit your doctor.)

In addition, the following may help your baby feel better, speed up the eradication of the infection, and prevent it from recurring:

• Change diapers immediately when your baby’s wet or soiled.
• Coat baby’s bottom with a diaper ointment between changes.
• Avoid using diaper wipes with ingredients that may cause stinging.
• Let your baby’s bottom dry thoroughly before re-diapering, and allow your baby to be naked for a time during the day.
• Avoid using plastic diaper covers. Instead, use coverings that allow air to circulate, or go cover-less if you’re not expecting a big poop anytime soon.
• Wash cloth diapers, cloth wipes, towels, and washcloths in very hot water to remove all traces of the yeast. A vinegar rinse will complete the disinfecting process.

Treating the mother
Talk with your doctor or lactation consultant about your suspicion of a thrush infection. She will confirm the diagnosis and prescribe a medication to clear up the thrush and any accompanying vaginal yeast infection. As mentioned earlier, if thrush is confirmed in the mother, the baby must be treated also, or the infection may continue to be passed back and forth between you. The following also can be helpful when treating thrush:

• Take an over-the-counter medication, such as acetaminophen (such as Tylenol) or ibuprofen (such as Advil), for breast pain; alternatively, try chamomile, skullcap, or low doses of valerian.
• Place ice packs on the nipples prior to feeding to reduce pain.
• Massage the breasts to stimulate letdown before attaching your baby to the breast.
• Start feeding sessions on the least painful side.
• Take extra care in ensuring a proper latch when nursing.
• Position your baby tummy-to-tummy with you for feeding to create a straight latch position and reduce pulling on the nipple.
• Break the suction with your finger to gently detach baby from your breast.
• Go braless or topless, or keep the flaps down on your nursing bra to allow your nipples to air dry.
• Avoid using breast pads, as these create a warm, moist place for yeast to thrive.

How to prevent recurring infections

• Clean and sterilize all pacifiers, teethers, and bottle nipples after each use.
• Let nipples dry after breastfeeding before covering them with clothing.
• Avoid letting your baby suck for long periods on a bottle or pacifier.
• Discard breastmilk that was expressed and stored during a thrush infection.
• Maintain diligent hygiene with frequent handwashing after breastfeeding, diapering, and using the toilet. Pay attention to underneath the fingernails, too. Wash your baby’s hands frequently.
• Avoid excess sugar ¾ that applies to you and baby.
• Add plain yogurt to your diet (and to your baby’s diet if she is eating solid food).
• Avoid fermented foods, such as cheese, beer, and wine.
• Wear clothing that allows the skin to breathe, and avoid synthetic fabrics.
• Use regular hand soap instead of antibacterial soap ¾ it kills beneficial bacteria that control yeast growth.
• Disinfect toothbrushes and mouth appliances regularly with a bleach and water solution, or put them in the dishwasher.
• Wash dishes in very hot water.
• Discard solid deodorants used during a thrush infection.
• If the thrush infection isn’t going away, have other family members and even pets checked to see if they are carriers.

Copyright Elizabeth Pantley. (McGraw-Hill, 2003)

About the author:
Elizabeth Pantley is the author of several books, including Gentle Baby Care : No-cry, No-fuss, No-worry — Essential Tips for Raising Your Baby, The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night, Kid Cooperation (with an introduction by William Sears, MD), Perfect Parenting, as well as her latest The No-Cry Sleep Solution for Toddlers and Preschoolers and is also president of Better Beginnings, Inc. She is a popular speaker on family issues, and her newsletter, Parent Tips, is seen in schools nationwide. She appears as a regular radio show guest, and has been quoted in Parents, Parenting, Redbook, Good Housekeeping, American Baby, Working Mother, and Woman’s Day magazines. Visit Elizabeth’s web site http://www.pantley.com/elizabeth.

A nursing strike can happen to breastfed and bottle fed babies alike. It often happens around six months of age when your baby begins eating solid foods. This can be stressful and difficult for parents and even if they don’t know it, for the baby as well.

Before their first birthday a baby’s main source of nourishment should be breast milk. If you are not breastfeeding then the baby should be mainly drinking formula, with baby food being only a secondary source for nourishment. Occasionally when your baby starts solids he will begin refusing to take the breast or bottle. If he does this there are several things you can do to help him get reaccustomed to the nipple.

1. Cut back on solids. If your baby has started refusing to nurse, cut back on the solids. It could be that you are feeding him TOO many solids and he is full.

2. Try to reintroduce breast. Put your baby skin to skin, letting him find his way to your breast on his own. Don’t force him, just lay there, acting like it is no big deal, and let him discover breastfeeding all over again.

3. Feed your baby when he is drowsy. If you catch your baby right as he is about to go to sleep, or just as he is waking up, you will probably be able to get him to latch on in his not-so-awake state.

4. Nurse baby before offering baby food. Use the baby food like a “dessert” with the breast milk or formula being the main course.

5. Try a cup. Often if your baby no longer wants the nipple, you will be able to get him to drink from a sippy cup and get his liquid that way.

Nursing strikes can be very common and is another one of those stages that your baby may or may not go through. Patience will help you persevere as a parent in helping to make sure that your baby gets the proper nourishment that he needs.

By Elizabeth Catalanotto

After exclusively breastfeeding your baby for months, becoming a pumping mom can be a challenging transition. Not only do you have to adjust to using the pump and fitting it into your daily schedule but you also have a whole list of decisions to make like what pump to use and how you’ll store the milk.

When it comes to using a pump for the first time, it can be a bit intimidating. However, if you take the time to plan and prepare you’ll be a pumping pro in no time.

There are two basic types of breast pumps available. Manual pumps that you control yourself and electric pumps that are run by small motors. If you’re apprehensive about using a pump, I suggest that you start with a small step and try a manual pump. Once you adjust to the pump and the idea of pumping it might be easier for you to begin using a professional grade electric pump.

The key to a successful transition from baby to pump is to give yourself time. Regardless of which type of pump you choose to use, your body will need time to adjust because it will not feel the same as your baby. Don’t be alarmed if you are only able to pump a small amount at first. Eventually, you will learn how to pump more effectively and will be able to express more during each session. By starting to use your pump early, you will also have the chance to build a backup supply of milk to store in your freezer.

When you’re adjusting to your pump, it can be helpful to pump on one side while nursing on the other. This will allow you to adjust the pump’s speed and suction close to your baby’s nursing pattern and it can help you develop a mental association between nursing and pumping.

Once you begin pumping, set a schedule and stick to it to ensure that you are able to keep your supply up and collect enough milk for all your baby’s feedings. When setting a schedule remember that it is better to pump more often than to pump for longer periods. Some moms pump every 3 hours while others prefer to pump according to their baby’s regular feeding schedule.

The goal of pumping is to recreate the experience of nursing your baby, so try to make each pumping session as relaxing and enjoyable as possible. Don’t feel that you have to multi-task while pumping. Take this time in your day to relax, think about your baby and enjoy a healthy snack. Remember that pumping is not simply a task that you must complete; it is an act of love that will give your child nutrition for the best start in life.

About the Author:
Elizabeth Catalanotto, a pumping/nursing mom to her 1-year-old daughter, promotes the benefits of breastfeeding and pumping at Breast Pumps Direct, an online store that offers quality breast pumps and accessories at discounted prices.

Some drugs can be taken by a nursing mother if she stops breast-feeding for a few days or weeks. She can pump her milk and discard it during this time to keep up her supply, while the baby drinks previously frozen milk or formula. Radioactive drugs used for some diagnostic tests like Gallium-69, Iodine-125, Iodine-131, or Technetium-99m can be taken if the woman stops nursing temporarily.

Drugs that should never be taken while breast-feeding include:

Bromocriptine (Parlodel): A drug for Parkinson’s disease, it also decreases a woman’s milk supply.

Most Chemotherapy Drugs for Cancer: Since they kill cells in the mother’s body, they may harm the baby as well.

Ergotamine (for migraine headaches): Causes vomiting, diarrhea, convulsions in infants.

Lithium (for manic-depressive illness): Excreted in human milk.

Methotrexate (for arthritis): Can suppress the baby’s immune system.

Drugs of Abuse: Some drugs, such as cocaine and PCP, can intoxicate the baby. Others, such as amphetamines, heroin and marijuana, can cause a variety of symptoms, including irritability, poor sleeping patterns, tremors, and vomiting. Babies become addicted to these drugs.

Tobacco Smoke: Nursing mothers should avoid smoking. Nicotine can cause vomiting, diarrhea and restlessness for the baby, as well as decreased milk production for the mother. Maternal smoking or passive smoke may increase the risk of sudden infant death syndrome and may increase respiratory and ear infections.

About this Article:
Provided by FDA

2004 EPA and FDA Advice For:
Women Who Might Become Pregnant
Women Who are Pregnant
Nursing Mothers
Young Children
FDA, EPA Revise Guidelines on Mercury in Fish
By Carol Rados

One minute you hear that eating fish is good for your heart. The next, you find out that eating certain types of fish can be harmful.

Actually, there are benefits and risks to eating fish. Fish and shellfish are an important part of a healthy diet. They contain high-quality protein, other essential nutrients, and omega-3 fatty acids, and fish are low in saturated fat. A well-balanced diet that includes a variety of fish and shellfish can contribute to a healthy heart and to healthy, well-developed children.

However, nearly all fish and shellfish contain traces of methylmercury, a type of mercury found in water that can be harmful, especially to unborn babies and young children whose nervous systems are still developing. Some types of fish and shellfish contain higher levels of mercury. The risks depend on the amount of fish and shellfish eaten and the levels of mercury in the seafood.

The Food and Drug Administration and the Environmental Protection Agency (EPA), through a joint consumer advisory, warn that women who may become pregnant, pregnant women, nursing mothers, and young children should avoid the types of fish and shellfish with higher levels of mercury and eat only those that have lower levels.

Here’s more information about the mercury in fish and shellfish, and what you should know.

Q. What is mercury and methylmercury?

A. Mercury occurs naturally in the environment and also can be released into the air through industrial pollution. Mercury falls from the air and can accumulate in streams and oceans. Bacteria in the water cause chemical changes that transform the mercury into methylmercury. It is this type of mercury that can be harmful to unborn babies and young children. Fish absorb the methylmercury as they feed in these waters. Methylmercury builds up in the tissue of some types of fish and shellfish more than others depending on what the fish eat. That’s why levels vary among species and locations.

Q. Should a woman who is not pregnant, but could become pregnant, be concerned about methylmercury?

A. Yes. If you regularly eat types of fish high in methylmercury, the substance can accumulate in your blood over time. Methylmercury is removed from the body naturally, but it may take more than a year for the levels to drop significantly. Therefore, it may be present in a woman even before she becomes pregnant. That is why women who are trying to become pregnant also should avoid eating certain types of fish.

Q. Do all fish and shellfish contain methylmercury?

A. Nearly all fish and shellfish contain traces of methylmercury. However, larger fish that have lived longer have the highest levels of methylmercury because it has accumulated over time. Large fish such as swordfish, shark, king mackerel, and tilefish pose the greatest risk. Other types of fish and shellfish may be eaten in the amounts recommended by the FDA and EPA.

Q. Where can I get information about the types of fish I eat?

A. Information about the levels of methylmercury in the various types of fish you eat can be found at the FDA food safety Web site: www.cfsan.fda.gov/~frf/sea-mehg.html or the EPA Web site at www.epa.gov/ost/fish.

Q. Should I be concerned about fish sticks and fast food sandwiches that are made with fish?

A. Fish sticks and fast food sandwiches are commonly made from fish low in mercury.

Q. Although advice is provided about canned tuna, what is the advice about tuna steaks?

A. Because tuna steak generally contains higher levels of mercury than canned light tuna, when choosing your two meals of fish and shellfish, you may eat up to 6 ounces of tuna steak per week.

Q. What will happen if I eat more than the recommended amount of fish and shellfish in a week?

A. One week’s consumption of fish does not change the level of mercury in the body much. If you eat a lot of fish one week, you can cut back for the next week or two. Just make sure to average the recommended amount per week.

Q. Where can I get information about the safety of fish caught recreationally in lakes, streams, and rivers?

A. Before you go fishing, check the appropriate fishing regulations booklet for information about recreationally caught fish. You can also contact your local health department for information about advisories in your area. Check local advisories because some kinds of fish and shellfish caught in local waters may have widely varying levels of mercury, depending on the levels of mercury in the water. Fish with much lower levels may be eaten more frequently and in larger amounts.

For More Information

FDA seafood safety Web site

FDA food safety information line
(888) SAFE-FOOD (723-3366)

EPA fish advisory Web site — list of state or local health department contacts

EPA actions to control mercury

Joint FDA-EPA advisory

Hiccups can be a big worry for many pregnant women and new moms. Why does their baby have them? Is their baby in pain from them? What can they do about them? Rest assured, most of the time the baby is not in pain, and the mother is more bothered by the fact that the hiccups have appeared, than the baby is having them.

Hiccups in Utero
Pregnant women often mention feeling their baby having hiccups while in the womb and wonder what causes this. These hiccups can start in the first trimester, but won’t be felt by mom until late in the second trimester or during the third trimester. Rarely do the hiccups bother the mother-to-be, however some moms might worry that it is hurting their baby.

The exact cause of your baby’s hiccups is unknown. However, many specialists believe that your baby’s hiccups may be helping to strengthen the diaphragm muscle in order to help the baby breathe both in the womb and once they are born. In many cases your baby will have the hiccups at the same time everyday.

Not only can hiccups be felt by the mom-to-be, but it can also be detected during an ultrasound and picked up on a Doppler while at the doctor’s office for a routine visit. After a woman has been assured that these hiccups are normal and are not bothering their baby, then they become something that can be looked forward to on a daily basis, much like their baby kicking.

Hiccups After Birth
If your baby had hiccups while in utero, it is very plausible that he will have the hiccups after he is born. Some babies that did not have them in utero may still have them after birth. Hiccups can start after birth as early as the day your baby is born. Like the hiccups your baby might have had in utero, these hiccups are generally not painful for your baby.

Hiccups after birth occur when the diaphragm muscle contracts causing your baby to take quick short breaths. Normally these hiccups go away after only a few minutes. If they are really bothering you, try burping your baby more often during feedings. To get them to stop you can try to feed your baby whether you are nursing or bottlefeeding. The constant sucking and swallowing can help that muscle relax and help the hiccups stop.