I recently heard a story about a woman who got an interesting discount, just because she was pregnant. She went into a sandwich shop for lunch one day, ordered her food and then was told that she got 10% off. She thought maybe the sandwich was on special and sat down to eat. Before she left the owner came over and told her that because of her being pregnant, she got a discount every time she came in and that in the future just sit down, tell him what she wanted and he would handle the rest.

While this special treatment was incredibly nice and thoughtful, and pregnant women all around the world probably think that more places should do this, it is not common to find places offering women special treatment just because they are pregnant. Most restaurants do not have discounts for pregnant women, neither do most stores you will find in your local town. Sometimes you can get lucky though.

One type of special treatment that many pregnant women in their third trimester would appreciate is a parking spot or spots reserved close to doors of shopping centers and grocery stores. By the time you are ready to deliver, walking a mile to buy some milk because you can’t find a close spot does not sound too exciting. Especially in the heat of the summer, or if it is cold, snowy, icy or raining outside. However, you can occasionally find these special spots at local grocery stores and chains. If you do you generally have to get a “pass” from the store that you hang in your window letting them know that you are in fact pregnant and they are only good in the third trimester and for the first couple of months after your baby is born.

It would also be nice if places like big amusement parks, where you are told you can not ride the rides, would offer discounts to pregnant women. Instead at most of them pregnant women are forced to pay the full price of $40 or $50 so that they can go in and walk around for hours while their family gets to enjoy the rides that they paid for. We are not aware of any amusement park that offers this type of discount, but if you are, please let us know so that we can tell all pregnant women to go there!

If you can not find a place in your neighborhood that offers special treatment to pregnant women, bring up the idea yourself. Mention it to the owners of your favorite restaurants, and to the manager at your local grocery store. Make them see that offering parking spots or discounts on food would help bring in the pregnant women who want to walk only 20 feet, instead of a mile, and those that don’t feel like cooking, but would rather just grab a quick bite to eat. Many times it is not done just because it isn’t thought of. After all, not everyone can be as smart as a pregnant woman.

By Brent N. Davidson, M.D.

Congratulations on the upcoming birth of your baby. It’s an exciting time and you probably have a lot on your mind anticipating the arrival of your new baby. It’s also a time that presents an opportunity to do something extraordinary for your baby and your family – the opportunity to preserve your newborn’s cord blood stem cells.

Currently, the stem cells in your baby’s cord blood can be used in the treatment of over 70 chronic or life-threatening diseases. Diseases like Leukemia and other cancers, genetic and blood diseases, and a range of immune system deficiencies. Plus, researchers are now looking to cord blood for answers to heart disease, stroke, diabetes and muscular dystrophy.

You only get one chance to preserve your baby’s cord blood. That’s why it’s critical to select a high quality cord blood company. Here are key questions to ask before selecting a cord blood company:

1. Is the company accredited by The American Association of Blood Banks (AABB)?

   Make sure the cord blood banking company you are considering is fully accredited by the American Association of Blood Banks (AABB) specifically for the processing of cord blood stem cells. The AABB is the only accreditation that ensures high standards of quality for the processing and storage of your baby’s cord blood.

   Some banks are fee-paying members of the AABB, but that’s not the same as being fully accredited. To be accredited, the cord blood banking company must have its laboratory and administrative procedures reviewed, inspected and validated regularly and their procedures must be compliant with the guidelines established by AABB for cord blood processing.

   It’s even better if the cord blood banking company you select is recognized by AABB as having procedures that represent exceptional and novel practices in the industry.

2. How experienced is the cord blood banking company and do they guarantee their product?

   You should ask the company you’re considering how many cord blood units they have stored, and whether they have facilitated any successful transplants.

   You should be cautious of a company that has a high number of cord blood units collected and stored, but has never or rarely used a unit for transplant. It could mean transplant physicians have rejected their cord blood – a warning flag that the company’s procedures are not thorough.

   Best of all is if the company offers a quality product guarantee. This ensures the fact that you are dealing with a quality-conscious company dedicated to providing the highest quality processing and cryopreservation of your baby’s cord blood.

3. Is the company financially stable?

   Cord blood banking is a costly industry. Some companies have gone out of business and parents actually have lost their cord blood units. Assessing a company’s long-term financial future is difficult, however there are a few critical questions you should ask. The first is, what the company would do with your cord blood if they were to go out of business. Be sure the company you are considering has a reasonable plan to accommodate customers, such as a formal written agreement with another medical facility where they would take over the management of the cord blood units.

   You should also ask how long the company has been preserving cord blood. In addition, you should find out if the company is a division of larger corporation, and whether there are academic affiliations, research collaborations and equity partnerships with major biotechnology companies. This would provide proof that the company is committed to researching and developing further applications for cord blood stem cell therapy and will most likely be around for the long term.

4. Does their service include bedside pick up by a Private Medical Courier and do they employ state-of-the-art tracking technology to ensure timely delivery?

   Look for a company that handles the logistics and uses a private medical courier to ensure the quickest, highest quality pick-up and delivery of your baby’s cord blood. The company should arrange to pick up your baby’s cord blood from your bedside in the hospital and transport it to the laboratory 24-hours a day, any day of the week, weekend or holiday. The company should manage all courier and transportation logistics, including accurate tracking of sample handling, and should be committed to transporting the cord blood unit to the laboratory within 24 hours of the baby’s birth to ensure maximum viability.

   The three areas proven to increase and maintain cell viability are timing, pressure and temperature regulation, all of which are controlled by the use of a private medical courier. This ensures the cord blood unit is kept at the proper temperature and pressure during transport and ensures the cord blood unit it delivered to the laboratory within 24 hours. With a private medical courier, your child’s cord blood gets to the lab quickly and safely while avoiding the potentially damaging temperature swings and pressure changes that happen with standard package carriers. This maximizes the number of cells that can be used in a transplant should you ever need them.

5. How does the company collect and store your child’s cord blood?

   Look for a company that uses the Gravity Bag Collection method (vs. Syringe method). The Gravity Bag is the collection method most preferred by doctors and it is designed to collect the greatest volume of cord blood. It’s the industry standard method used by the majority of blood banks and similar to the methods used by the American Red Cross and the National Institutes of Health. It is important to collect as much cord blood as possible, as results show that larger samples produce more viable stem cells. The Gravity Bag method allows for the most cord blood to flow into the bag. In addition, the closed tube/bag system eliminates exposure to airborne bacteria and greatly reduces likelihood of contamination during collection. Be sure the company you are looking at provides a sterile collection protocol to allow for collections to be performed during C-sections and emergency births.

   Look at how the company stores the cord blood after processing. Look for a company that cryopreserves the processed cord blood in multi-compartment, transplant-ready Cryobags. Cryobags allow for higher cell recovery rates and a higher cell viability rate compared to other storage methods like Cryovials. While storage in Cryovials is less expensive for cord blood companies, it does not maximize the value of the stem cells for families. The superiority of the Cryobags allow for higher cell recovery and higher viability than Cryovials.

   Additionally, the company should store a small amount of processed cord blood in aliquots – a small compartment of cord blood designed for pre-transplantation testing. The benefit is that the testing can be done without disturbing the primary compartments. With the Cryovial method, an entire vial must be thawed and used to perform this necessary pre-transplantation testing procedure.

6. Does the company have a Medical Scientific Advisory Board (MSAB) made up of notable authorities in the field of cord blood stem cell preservation and transplantation?

   The company you are considering should have a Medical Scientific Advisory Board (MSAB) made up of thought leaders in the field of stem cell transplantation and cord blood preservation. Ask how the company uses their MSAB. They should meet regularly to set quality standards within the company and thereby help to maintain the highest and most advanced level of service available.

7. Is the company committed to research for future applications of cord blood?

   Look for a company that actively participates and invests in research and development of cord blood stem cell therapies. If a cord blood company is committed to research, it’s a good indication that the company is also committed to the future, which means they are more likely to have financial stability. Another potential benefit — any medical breakthroughs developed by their R&D division will have been conducted using their own processing and cryopreservation methodology. In other words, you may be in a better position to benefit from their discoveries by using their processing techniques as opposed to methods used by other cord blood companies.

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.

Unlike the baby blues, postpartum depression is a severe form of depression that affects 10-20% of new mothers and at times new fathers after the birth of their baby. It may not easily pass, and in some cases medical intervention may be necessary. It can normally be diagnosed as early as one month postpartum, after the baby blues should have faded. A woman’s doctor or midwife can prescribe medications if needed.

Causes of PPD
Not all causes of postpartum depression have been identified but there are some ideas and known facts in the medically community. Postpartum depression might be caused by the following things:

• Anti-natal depression
• Low self esteem
• Childcare stress
• Prenatal anxiety
• Life stress
• Low social support
• Poor marital relationship
• History of previous depression
• Infant temperament problems/colic
• Maternity blues
• Single parent
• Low socioeconomic status
• Unplanned/unwanted pregnancy

There are other factors that may cause women to have postpartum depression. In many ways it is one of those situations where it is different for every woman.

Symptoms of PPD
Like the causes, the symptoms of postpartum depression vary widely. Some include:

• Anxiety
• Irritability
• Insomnia
• Feelings of guilt
• Difficulty concentrating
• Persistent weepiness or sadness

These are similar to the symptoms of the baby blues, however they are much more intense when connected to postpartum depression. If a woman feels these symptoms strongly after her baby is born she should visit her doctor to see if he can help.

Postpartum Psychosis
Extra severe cases of postpartum depression can be referred to as postpartum psychosis. Postpartum psychosis is very rare occurring in just 0.1-0.2% of women who have recently had a baby. Postpartum psychosis includes all of the severe symptoms of postpartum depression, but it can also often include the mother having hallucinations and delusions.

Treatment
The good news is that there is treatment available for postpartum depression and even postpartum psychosis. There are medicine’s that can be prescribed, including medicine that is safe for breastfeeding women to use. Your doctor might also recommend counseling. If postpartum psychosis is diagnosed within the first couple of days it is often possible to reverse the effects within a few weeks with medicine vs. it taking several months to cure, even with medication, if not diagnosed right away.

If you think you may be suffering from postpartum depression it is important to remember that you are not alone and that there is help out there. Be sure to make an appointment with your doctor to get help.

One of the most common causes of severe diarrhea among infants and children is a virus that most mothers have never even heard of…the Rotavirus. Until my first son got it, and was hospitalized because of it, I had never heard of it. After that experience I made sure that my second son received the vaccine at his two month well-check.

What is the Rotavirus? It is a virus that not only most children get by the time they are 3 years old, but most people get it every year. However, the symptoms range for each person. For a child, generally the most severe is the first time it is contracted. For adults it is likely to just cause a little diarrhea or stomach ache, which most would hardly notice. It is estimated that 70,000 children are hospitalized, and another 150,000 are brought into emergency rooms each year. Approximately 100 children die each year from Rotavirus complications.

Rotavirus has an incubation period of about two days and the symptoms of Rotavirus include diarrhea, fever and vomiting. Some experience severe abdominal pain as well. Rotavirus also as a distinct odor to it — many say that once you have smelled it, you will never forget it. Rotavirus can last anywhere from three to nine days. Once you have it you can become immune to it, however like the common cold there are many different strains in the world that you can be infected by.

Rotavirus in its’ worst form can also be the cause of severe dehydration in infants and children. Signs of dehydration include dry, cool skin, sunken eyes, dry mouths, absence of tears when crying, and lethargy. It is important to watch your baby for these symptoms and try to keep him hydrated so that you can avoid hospitalization.

There is very little treatment for Rotavirus once it has been contracted; however they now have a new vaccine available for an infant that is taken orally. It is very contagious and is often transmitted from fecal to mouth when children do not wash their hands after using the bathroom. If you have older children and an infant in your home, it is very important to teach your older children how to properly wash their hands in order to help avoid your infant from catching the virus.

If your baby is sick and you think he might have the Rotavirus, call your pediatrician and have him seen. Your pediatrician might have suggestions to help keep your baby hydrated or more comfortable.