Breastfeeding is nature’s arrangement for survival of the baby. The constituents of this milk are just perfect for the little one and it is the safest and most complete meal that a newborn can get. While feeding, vital antibodies are passed from the mother to the baby which play a crucial role in the development of his immunity. There are a number of health benefits of breast feeding. During the first year exclusive breast feeding lactation can considerably bring down the risk of breast cancer in women. Let us understand how breastfeeding and cancer are inter-related with the help of the given reasons:

• Your breast cells are making milk continuously for the first year and this does not allow the breast cells to misbehave
• Breastfeeding acts as a natural contraceptive and the menstrual cycles are also fewer. This results in lower estrogen levels.
• A healthy diet and lifestyle that most women follow during breastfeeding helps to keep cancer away.
• The incidence of breast cancer in lactating mothers is as low as 3% so it is a proven fact that breastfeeding reduces the risk of breast cancer.

Out of the many problems that affect females in the reproductive age group, cancer is one of them. It can be benign or malignant. They type and the stage of the disease will determine the prognosis and the outcome. The benign lump in breast is the commonest presentation. If the cancer is detected early, the lump can be surgically removed. However if the cancer has spread to other parts, then the patient may need surgery combined with chemotherapy or radiotherapy. In such conditions you may be concerned whether you can breast feed your baby. We shall discuss the pros and cons in detail here.

Pathological Conditions Of The Breast

In order to understand the relation between breastfeeding and cancer, you need to understand the pathological conditions first. Women who are lactating are the most prone to getting breast affections. Majority of the cases are not cancerous but just simple lumps. The causes of these lumps in breast are:

(a) Mastitis: This is an infection of the breast that is caused by the blockage of the milk duct. The milk collects and becomes a site for bacteria formation and infection. The symptoms of blocked milk duct are tenderness pain and swelling of the affected breast. The skin of the breast is tense and warm to touch.

(b) Fibroadenoma: This is a benign tumour that affects the breast. On palpation with the fingers, these lumps feel hard, non tender and they tend to slip beneath the skin on applying pressure. It is described by ladies as a lump under the left breast.

(c) Breast Abcessess: This is a painful condition where there is an abscess (lump on boob) formed beneath the skin in the breast tissue.

(d) Galactoceles: They are small breast cyst that are milk filled. Breastfeeding lumps are generally harmless

Benign lumps of the breast are usually hard and movable when palpated. Cancerous growths in the breast are irregular in shape and non movable.

Breastfeeding and Cancer

Breast Cancer

Symptoms: The presence of lumps in the breast that are painful and fixed usually raise the suspicion of cancer. The other symptoms of breast cancer in feeding mothers is abnormal discharge from the nipple, breast pain, change in the shape of one or both the breasts, puckering of the skin, swelling of the breast and warm to touch.

If the lump in the breast grows bigger or becomes painful and fixed then you should see the doctor immediately. Another change is dimpling of the breast skin which is called peau d orange appearance and a shift in the normal position of the nipple are warning signs.

Diagnosis: The diagnosis of breast pathologies is normally done by breastfeeding cancer signs, clinical examination and diagnostic techniques like mammogram. A mammogram gives the complete information of the breast duct system present within the breast. A lump or lymph nodes can be easily picked up. If required, a confirmatory biopsy may be done. The cells obtained on the biopsy are microscopically checked for cancer cells. In lactating mothers, reading of a mammogram is difficult so the doctor may advise the mother to stop feeding before having the test. Another test is ultrasound of the breast.

In case you have a doubt about the safety of the procedure that you will be undergoing while breastfeeding, talk to your doctor about it and discuss the probable side effects and precautions that need to be taken. Breastfeeding and cancer treatment can’t be followed at the same time.

Treatment: If a nursing mom has breast cancer, she will need surgery, chemotherapy and radiation. Depending on the stage of the disease, the line of treatment will be decided. The common known side effects are fatigue, pain, weakness, nausea and weight loss.

(a) Surgery: Surgery is the safest option during breastfeeding. You can continue to feed before and after the operation. The time gap that needs to be given will depend on the condition of the tumour and the extent of the surgery.

In case the cancer has spread to both the breasts and it is malignant, then you will need a double mastectomy. Removal of both the breasts will make the mother unable to breastfeed.

If only one breast is affected, then lumpectomy can be done to remove the tumour locally, followed by radiation therapy. If radiation is given it means the milk production will be affected and there will be very little or no milk at all. The mother may however feed from the normal breast. However, breastfeeding and cancer treatment at the same time need your doctor’s approval.

The medications that are given post surgery and during radiation tend to pass through the breast milk. So you discuss the probability of breast feeding with the doctor in advance and if required pump and store the milk for the baby. Before you resume breast feeding, discard some of the milk so that there is no risk of passing on heavy medications to the baby.

(b) Chemotherapy: Chemotherapy breast cancer may be indicated in your case. In this case you will have to stop breastfeeding the baby. This is because the breast cancer medicicne used are very strong and can have side effects on the baby.

(c) Radiotherapy: In some cases, it is possible to feed when you are on radiation therapy. This will vary in each individual case. Breastfeeding from the unaffected or normal breast is usually recommended.

How To Cope With Breast Cancer: During breastfeeding and cancer treatment, it is very essential that you arrange for proper child care and family support as you can be in bad shape and physically unable to nurture the baby for a while. Pump and store your milk or switch from breastfeeding to formula. This decision needs to be taken after consultation with the doctor regarding the severity of the disease. The stage at which the cancer is detected is the most important deciding factor. So work out with your doctor what mode of treatment will suit you best so that you can continue to feed your child. Join an online support group and reach out to other mothers who are in a similar situation for cancer advise. This will help you a lot in the recovery process. Take help and learn as much as you can about breastfeeding and cancer to avoid health concerns.

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The nine month long wait is finally over and your little baby in here in your arms. With the end of labor and pregnancy, there begins an all new chapter in a women’s life and that is motherhood. The things that worried you just a few months back like pregnancy signs by week have now been replaced by baby blues symptoms. The reason is that just after giving birth, there are changes happening within the body each minute. An all new routine, baby care, newborn feeding and the turmoil created by hormones can be quite overwhelming for first time parents. This postpartum period needs to be tackled very carefully. The more care you take now, the easier it will be to get back to your pre pregnancy shape and avoid the possibilities of postpartum complications.

There are some postpartum complications that are common during this post partum period and we shall discuss them in details here. You will also learn some of the red flags that you need to identify and rush to your doctor at the earliest.

Postpartum Complications

1. Infections during the postpartum phase. Postpartum infections could be of the urinary tract, bladder or kidney infections. You must take very good care and maintain hygiene. The main presentation will be fever. The accompanying symptoms along with the fever will help in establishing the diagnosis.
2. Bleeding after pregnancy is called as lochia. This comprises of the wastes that are left behind post delivery. The discharge is brownish and later on it becomes reddish in color. Then it gradually becomes pale and scanty and stops. In some cases there may be excessive bleeding along with passing of big blood clots due to conditions like retained placenta when a small bit of the placenta has been left behind. In cases of severe bleeding, dilatation and curettage may be required.
3. Localized infection of the wound site either at the site of episiotomy or the C-section scar may get infected and give rise to pain and swelling along with tenderness. There can be a foul smelling discharge from the affected site. It will need proper and systematic wound care and dressing.
4. Mastitis or swelling of the breasts can also happen especially in breast feeding mothers. There will pain and redness of the affected breast along with fever. The mother will be unable to feed from the affected side. If the milk duct gets blocked it can also lead to a breast abscess. Such cases need surgical incision and drainage of the abscess.
5. Urinary incontinence may occur in some of the cases because of the weakness of the pelvic and urinary muscles. In some ladies, it may also lead to pain and discomfort during sexual intercourse.
6. Excessive strain on the blood vessels of the pelvis by the growing fetus may lead to engorgement of the veins and hamper the normal venous return thus leading to hemorrhoids and constipation. Avoid straining at stool and use a laxative so that the stool is not very hard. A good fibre diet and plenty of water will also play a major role in keeping constipation away.
7. Postpartum Depression is one of the severe postpartum complications that occurs in the initial few weeks. Pregnancy depression is quite common and has to be dealt with very delicately. There are a very small percentage of mothers who identify the symptoms and seek help for such conditions.In the first four weeks post delivery, the mother may have mood changes and irritability as she adjusts with the new routine. These are called baby blues symptoms. However when these symptoms intensify, and the mother become incapable of taking care of herself and the baby, then they are categorized as postpartum depression symptoms. This kind of illness is seen more often in women who are single parents or if the pregnancy was unplanned and unwanted. Pregnancy depression is also an identified risk factor in such cases.

What Are The Symptoms of Postpartum Depression?

The symptoms are somewhere similar to those of depression. They include irritability at the smallest things. The anger may also become violent and aggressive. There may be outbursts of crying and a feeling of guilt that she is not able to take care of the baby. Many mothers also have sudden outbursts of crying without any reason. They are unable to accept the fact that they are not feeling happy at the birth of their baby and this further increases their suffering. Strange food cravings and sleeplessness may also be seen.

Management of Post Partum Depression

Most cases will do well with counseling and a strong family support system. Once the problem is identified, you must ensure that you have some kind of helpat least for a few months till you are able to get back to normal. This will help you to recover and also reduce the number of outbursts. Counseling sessions work well in such postpartum complications. The husband and the family members also need to be explained about the situation so that they can deal with the  mood swings and outbursts.

In a very small percentage of postpartum psychosis cases, there may be danger to the child as the mother may lose control over herself. In such cases the mother needs hospitalization and treatment with antipsychotics and mood stabilizers. Some of these medications may not be totally safe for breastfeeding mothers so that aspect should be considered. The child should be kept in safe custody of a parent or guardian till the mother recovers completely.

The nurse and healthcare professional must talk to the patient so as to rule out any signs of    postpartum depression. This is important because it is less likely for a new mother to come up and share such unusual feelings. If your suspect anything, you can discuss it with the patient or better arrange a counseling session for her.

The message that we need to take home is that each lady needs to care for herself after delivery in terms of food, nutrition, health and make sure that you have someone to share your feelings with. A good support system in place can help prevent complications like postpartum depression.

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The initial few weeks after having a baby are the busiest days for any mother. In the midst of diaper changes, breastfeeding and night waking, there is little time that you may get for yourself. Amidst all this postpartum exercising may be the last thing that you have on your mind. But if you are able to find time for it, it will be the best gift you can give your body.

During pregnancy, the pelvic floor and belly muscles stretch to their maximum limit. Immediately after the child is born, these muscles bounce back. However they cannot go to their original shape immediately. The uterus that had expanded during pregnancy may take a full year to involute and come back to its normal shape. Similarly the muscles of the abdomen tend to sag. Systematic and planned muscle toning exercises can help you get back to your normal shape soon. A post baby diet and exercise plan can be made according to your body type and medical condition.

How To Begin An Exercise Regime?

How to lose weight after birth? If you have had a normal delivery, you can begin exercising immediately once you get home. If you have been active and also working out throughout your pregnancy, then it will be easier for you. Begin with light exercises like walking. If you have had a C-section delivery, then you need to wait till your gynecologist gives you the permission to start exercising. You may begin walking but exercises for the toning up of muscles and weight loss should be started after a six week wait or once your doctor allows you. The reason is that the scar of the C-section takes a while to heal and if you over do the abdominal exercises in the early days, you may cause pressure on the scar. It may also increase your chances of developing a hernia later on. The scar needs to heal completely before you can do abdominal muscle exercises like crunches and sit ups.

(a) First few weeks: To begin with you must start walking for 10 to 20 minutes a day. Walk with moderate speed and gradually over a month or so, increase the speed and the length of your walk. Walking is the best way to lose weight after pregnancy.

Crunches and sit ups are not advisable in the early days. Instead take the help of a physiotherapist who will be able to guide you with postnatal exercises that involve breathing in and holding the breath while you pull your abdomen inwards. Pelvic floor exercises should also be done during this time. This kind of exercise variations are very helpful in tightening of the abdominal and pelvic floor muscles and it is the best way to tone your body. You will begin to see the effects only after a few weeks as these toning exercises take a while to show the results.

You must take care to avoid swimming in the early weeks, as you will be bleeding. Once the lochia discharge stops, you may begin.

(b) After three months: After 6 weeks of your delivery, you begin feeling normal again and your c-section scar is healed. Many mothers begin planned weight loss exercises after a few months of giving birth.

Types Of Postpartum Exercising

1. Lower abdomen muscles:You can try a number of exercises. Begin with the breathing in and holding the breath while contracting the abdomen muscles and pulling the pelvic floor inwards. Hold this position for ten seconds and then release. Do repetitions of the same.You can also do this exercise using an exercise ball. Sit with both your feet touching the ground. Lift one leg and squeeze your tummy and pelvic muscles and hold the position for a while. Repeat five to ten times on each leg.You can check out the videos of post pregnancy ab workout to get a better idea about the postpartum exercising.
2. Pelvic muscles:You can do pelvic tilts while sitting or lying down. Do this by pulling in the pelvic muscles and pushing down the back that is arched. Hold the position and then release. Never hold your breath during these exercises. These are good for your back and pelvic muscles.
3. Upper Back and Neck:As a breastfeeding mom, you may sitting in a slouched position for a lot of time. Straighten your hands above the head and stretch your arms and twist from side to side. Another exercise is to hold your arms up for a few seconds and then bring them down.To strengthen your neck muscles, do side to side movements and rotate your neck slowly. This can help you with the stiffness and pain in neck.After few months go by, you can shift to more intense exercises like planks, sit ups and crunches so as to strengthen your lower abdomen. You can also enroll yourself in postpartum weight loss program.

Advantages Of Postnatal Exercising

1. Depression after childbirth is a common problem as you tend to get overwhelmed by all the changes and your hormones add to the trouble. Exercise releases endorphins in the body and make you feel good. It helps to uplift your mood.
2. You can try yoga after delivery which is a steady and safe method to lose weight. It also helps you relax mentally and you are able to cope up much better with the changes around you.
3. Exercise helps to prevent aches and pains and boosts your energy levels.
4. You can do these exercises at home using work out videos for women post delivery or join postnatal fitness classes. Whichever suits you best can be selected.

Lastly a word of caution, if you experience bleeding or pain after any postpartum exercising, make sure to visit your doctor. Do not begin strenuous exercises without medical advice as it may land you in complications. In the initial weeks or months, restrict yourself to muscle strengthening exercises and gradually increase the intensity. Swimming as a part of postpartum exercising should be avoided in the first six weeks after giving birth.

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Causes of Post Partum Depression

You may wonder what causes depression. The exact cause of post partum depression is not known but it is believed to be hormonal in origin. The hormones responsible are estrogen, progesterone, testosterone, cortisol and thyroid hormone. The other causative factors are environmental and genetic. The mothers who had anxiety and panic attacks during their pregnancy are more prone to having such symptoms later on. The baby blues are not because of something the mother did or could not do. The causative agents are beyond your control.

There are some risk factors that have been identified to be present in the background in such cases of depression.

1. Family history of depression
2. Prenatal anxiety disorders
3. Child birth related physical and psychological trauma
4. Formula feeding rather than breast feeding
5. Lack of social support
6. Strained marital relationships
7. An unwanted or unplanned pregnancy
8. High prolactin levels.

Symptoms of Post Partum Depression

The presence of a combination of the below mentioned symptoms lasting for more than two weeks at a stretch fall in the category of post partum depression

1. Severe mood swings
2. Persistent sad and gloomy mood
3. Low self esteem
4. Difficulty in bonding with the baby
5. A feeling of guilt
6. Having trouble in taking care of the baby
7. Overwhelming feelings
8. Crying without any reason and feeling weepy all the time.
9. Difficulty in taking decisions
10. Getting angry or irritated very easily
11. Loss of appetite
12. Delusional thoughts are rare presentations of PPD.
13. Impulsive behavior that could harm the baby. When you feel that your actions could harm the baby, you must seek immediate medical help.

Diagnosis and Treatment of Post Partum Depression

The presence of the symptoms of PPD anytime during the pregnancy or within the first two weeks post delivery is the main stay of the diagnosis. The main differential diagnosis here are baby blues which are mild forms of the above mentioned depression symptoms. Postpartum psychosis is another condition similar to a bipolar disorder but the presentation is severe and it is a psychiatric emergency.

The main aim of treating post partum depression is to identify the cause or risk factor and rectify it. The treatment for depression could be done by medications like SSRIs- selective serotonin reuptake inhibitors. They are very effective in treating PPD and also considered safe for breast feeding mothers. The medication does pass on in the breast milk but the amount is very small so it is not harmful to the baby.

The non medication methods of treatment include psychotherapy and counselling sessions. Counselling for post partum depression has been found to be the most effective. Group therapy and cognitive behavior therapy are also effective in dealing with the symptoms of post partum depression.

The chronic depression treatment is very important because untreated symptoms can become severe and pose a life risk to the baby. The mother will close in further on her troublesome symptoms and the situation may go out of hand. So always remember that help is available and you do not have to go through this phase. It is treatable and you can get better and enjoy your baby once again.

How To Get Help With Post Partum Depression

1. Take enough rest. Nap when your baby naps and get help for household chores and other outside work. Taking help from family members is more advisable as you can rely on them and also your mother could help you out with small things for the baby.
2. If you are facing symptoms of depression, do not stress about it as it will only make the matters worse.
3. Take help and go for counselling sessions and interact with other mothers who are facing a similar situation. By doing so you can bounce back sooner and feel good about you. Rehab for depression is not common for PPD as you have a little baby to nurture.
4. Pamper yourself and take a nap or a warm relaxing bath or watch your favorite television show while your husband plays with the baby and order out dinner. These small things are sure to make you feel better.
5. Take your baby for a walk in the stroller every evening. Get some fresh air and make new friends. Having a friend who is also a new mother will give lots to share and talk about. It will take away the stress and you will be able to cope better.

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Most of the moms will have this topic in their minds and on their Google searches by the time their baby is 6 months old. Baby weaning technically means transitioning your baby from breastfeeding to solid foods. Many people also refer to weaning from breastmilk to formula. The basic idea here is that at the baby grows older, breast milk is not longer enough as the main source of nutrition and so you have to introduce semi-solid and gradually solid foods to complete their nutritional requirement.

There is no fixed time for weaning your baby. The best way to wean is to look for signs from the baby. If the baby begins to show interest in the food plate on the table and is getting impatient while nursing, it is probably time you weaned him onto solid foods. Weaning however does not mean that breast feeding should be stopped. It is a very important and essential thing for you to feed the baby exclusively for 6 months. Thereafter you can gradually reduce the feeding one session at a time and introduce solid food along with the baby formula. It is recommended that the first feed that you can drop is the mid morning one, followed by the day, evening and finally the bedtime feed. Feed your baby a little and then offer the first bowl of food. The first time your baby takes solids, he may not like it and even spit it out. So, you must begin with a very small quantity and gradually increase the number of spoons once in a few days.

Types of Baby Weaning

There are two main types of weaning- baby led weaning and mother led weaning. Baby led weaning is the term used when the baby weaning is decided based on cues given by the baby. Disinterest in breastfeeding and readiness to sit are some of the signs that your little one is ready for his first spoon. This approach also encourages the baby to eat on his own, however messy it is. It helps them to feel the food and makes the eating habits much better as the child grows up. Mother led weaning is the commonest type of weaning these days where the mother decides when to start the baby on solids. If the mother is planning to go back to work then she might decide to switch from breast to the bottle. When doing so, always remember that sudden stopping of the breastfeeding will prove to be harmful for both you and your baby. Your baby will get cut off from the intimate feeling and comfort associated with breast feeding. On the other hand, you will experience health problems like engorged breasts and formation of lumps in the breast if you abruptly stop feeding your baby. So baby weaning should be a gradual and methodical switch over from the breast to the bottle or solid foods.

Good Baby Weaning Habits

1. Weaning off breastfeeding is a very difficult task. Skip one feed at a time and in place of that feed, give a bottle or a semisolid meal. Drop the next feeding after two weeks. This way the transition will be gradual and your baby will get time to adjust. It will also prevent mastitis and swollen breasts in the mother as the milk supply will diminish gradually.
2. Make the feeding sessions shorter and after a while, offer the cup or baby bottles. Do this for the day feedings. You will notice that the last feedings to be dropped are the night ones. That is because the baby feeds for comfort and the feeling of being close to you gives him a sense of security. So, try it slowly with formula and breastfeeding.
3. Try to postpone the breast feeding session and try to give the bottle instead. You can also try to put a few drops of breast milk in the mouth and then offer the bottle nipple to the baby. These are just small tips and you should follow the cues given by your baby and do what you feel is best. A mothers instinct is the biggest guide that you can get.
4. Always introduce only one new food at a time and give that to the baby for at least three days. By doing so you can ensure that the baby is tolerating the food well and also find out if he has any food allergies. If you see any such symptoms, you should stop that food item and keep it in mind for the future too.
5. When you introduce solids, try to give a variety of fruits and vegetable purees to the baby. Ensure that the diet is balanced and well spaced. This will provide the baby with the important nutrients. If you child does not feed well, you may need to give a few supplements like B complex, vitamin D etc. Always use an iron fortified cereal or formula for your baby to minimize the chances of iron deficiency anemia.

There are times when the baby is not ready for solids or falls sick after introducing new foods. In all such conditions, do not panic and get the child on breast feeding again. It will nourish the child and also calm him down when he is crying due to being unwell. You can try again after a few days or a week. Remember, it is not easy to transfer a breastfeeding baby into weaning baby.

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Methods of Contraception

There are many effective birth control options available these days. Here we shall discuss few of them in details:

1. IUDs-IntraUterine Devices: IUDs are small intrauterine devices that are impregnated with hormones. They are commonly known as copper T or copper iud. It is a T shaped device that is inserted into the uterine cavity. The mode of action of the IUD is that it elutes hormones or copper that make the cervical mucous thick thus preventing fertilization. It also prevents ovulation and stops uterine wall build up. The most effective kind of IUD is the levonorgestrel (progesterone) releasing intrauterine device. It provides contraception for a period of five years. An iud is recommended for those women who have already had their first child. Common iud side effects include spotting and cramping pain the abdomen. The efficacy rate is known to be 99%.
2. Barrier Methods: Barrier methods of contraception are those devices that physically prevent the entry of the sperm into the uterine cavity and thereby preventing fertilization and pregnancy. These include male and female condoms, cervical caps and diaphragms and contraceptive sponges with spermicide. This is the commonest over the counter birth control option.Condoms are the most popular and effective barrier method. They are commonly made out of latex, are easy to use and inexpensive. This method involves putting on a condom over the erect penis of the male. This prevents the entry of the sperms into the cervix of the female partner and thereby prevents the female from conceiving. Another very important use of the condom is that it prevents the transmission of sexually transmitted disease in individuals having unprotected sex or having illicit sexual relations. The commonest mode of transmission of HIV/AIDS and other STDs like syphilis and gonorrhea is via sexual intercourse. There is a small failure rate associated with condoms due to improper usage or tearing of the condom but it accounts for a very small percentage of cases.
3. Hormonal Methods and Contraceptive Pills: There are two types of contraceptive pills. One is the estrogen progesterone pill and the other is the only progesterone pill also called as mini pill. Both these provide contraception by preventing ovulation and thickening up the cerival mucus. In turn both these will prevent the egg and sperm from fertilizing and thereby the chances of a pregnancy become zero.The pill is often associated with side effects like breast tenderness, headache and nausea due to the effect of hormone estrogen.Other hormonal methods are contraceptive implants under the skin, birth control patch and injections. The commonest injection (birth control shot) used is depo provera which provides contraception for a period of one year.
4. Sterilization Surgery: Surgical sterilization is method of providing permanent contraception. It is available as vasectomy or male birth control and tubal ligation in females. In males, the vas deference that carries the sperms is ligated and in females the fallopian tubes that transport the egg to the uterine cavity is ligated. In both the cases, there is a creation of a mechanical block due to which the egg and sperm cannot meet and thereby the chance of a pregnancy is ruled out. This option is suitable for those females who already have two or more children above the age of 5. Although it is a permanent surgical procedure, if needed surgical re-canalization can be done. This mode of birth control does not provide any protection against sexually transmitted diseases.
5. Emergency Contraception: Emergency contraceptive pills are used mostly after an episode of unprotected sex with a hope of preventing a pregnancy. They are also referred to as the morning after pill. The mode of action of these pills is to prevent ovulation and fertilization. They do not provide any protection against sexually transmitted diseases. The various options include high dose contraceptive pills, ulipristal which has been found to be more effective in obese subjects, levonogestrel, mifeprestone and IUDs.
6. Breastfeeding : A breastfeeding mother usually has lactational amenorrhoea for the first six months. This period is known to be a natural contraceptive. The two pre-conditions here are absence of periods and exclusive breast feeding of the baby. This is not an absolute contraceptive period and in many females, fertility returns early and they can conceive even when they are breast feeding.

Advantages of Using Birth Control

Birth control has multiple benefits. It provides freedom to the couple to have a normal sex life without the fear of pregnancy. There are a multitude of options available and the couple can choose what suits them the best. Contraception helps to space the children adequately and also provide the mother time to recuperate from the first pregnancy. Children born very close in age gap, make it very difficult for the mother as her body barely gets any time to recover from the strain of the first pregnancy. This was one major reason behind high infant mortality rates in some Asian countries. Barrier methods provide protection against sexually transmitted diseases. The awareness of STDs in today’s youth is very important as it can prevent unwanted teen pregnancies and transmission of HIV/AIDS.

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Your little baby will wake up each day with a small new change. One fine day you may wake up and see little red bumps on baby face, particularly his cheeks. This baby rash is commonly called baby acne and they are commonly seen on the cheeks. There is no fixed known cause behind this acne breakout. Baby acne should be differentiated from milia. Milia are small white spots seen on the face immediately after birth. Milia are not related to the acne and both these conditions tend to resolve on their own.

Characteristics of the Eruptions

Baby face pimples or acne are little red bumps seen on the face, mostly the checks. They can occur on the back due to an allergy to the detergents in the clothes or itchy clothing. The bumps can be present from birth and they go away on their own after two to four weeks. If the eruptions linger on for more than three weeks, then you should consult your doctor. The location of the eruptions decides the diagnosis. If multiple such eruptions are seen on the scalp and are associated with itching and scaling then it is most likely to be skin problems called cradle cap which is very common in small babies. You can find infantile acne pictures on the web and see how the eruptions look.

Causes of Baby Acne

The exact causes of acne are not known but as in case of adolescent acne, the baby acne also have some relation to the maternal hormones. The surge in the hormones of the mother at the end of the pregnancy, are the most likely cause of newborn rash. At times, certain medications that the mother takes are also responsible for causing the acne. If you feel that any baby product that you are using could be causing the acne or rash, you must discontinue it immediately and use only safe and certified baby products.

Treatment of Baby Acne

Usually the acne tend to resolve on their own but if they last for more than a few weeks, then you need to consult your doctor. The treatment of baby pimples is very different from that of adult acne treatment. He may prescribe a cream or lotion for the same. Medicated creams need to be used here. Never use over the counter washes or creams for your baby as their skin is very delicate and sensitive. A strong skin product may lead to a skin reaction of adverse nature.

Home Remedies for Baby Acne

There are some useful home remedies that you can try for baby acne and keep your baby’s skin as healthy as possible. The most important is baby skin care.

1. Cleaning the face: Always clean your baby’s face twice a day. Do so by using warm water and a mild baby soap or moisturizer. If your baby’s skin is sensitive, you could use a medicated soap as suggested by your pediatrician. Always take care that you do not use any other soap or skin treatment creams, as they can lead to burning in the eyes. Baby soaps and products are made especially with a no tear formula so that even if the soap goes into the eyes, the baby does not have any burning or pain.
2. Scrubbing: Always remember that you should never scrub your baby’s skin as it is very delicate and soft. Whenever you clean the skin, it should be with gentle circular motions with moderate pressure. Scrubbing can damage the superficial layers of the skin and lead to bruising.
3. Creams and Lotions: If your baby keeps getting acne and bumps, he could be having an oily skin. Using any sort or cream or lotion will only aggravate the condition further and increase the number of acne. You should never use over the counter medications for your baby. This is a very important tip for infant acne treatment.
4. Never squeeze: You should never try to squeeze the acne or try to puncture it in an attempt to clear it out. By doing so you will cause unnecessary pain to the baby and also irritate the skin making it more vulnerable to infections.
5. Wait and Watch: You need to be patient as a parent and understand that newborn acne are not a serious medical illness. It is a skin breakout and will resolve on its own. More importantly the acne are not causing any trouble to the baby and so you also should be rest assured and just wait for it to clear up on its own.

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Hepatitis is basically the inflammation of the liver. It can be acute or chronic in nature and the commonest causative organisms are viruses. The main function of the liver in our body is production of bile to aid the process of digestion. It helps in the metabolism of carbohydrates, fats and proteins. It is responsible for the excretion of bilirubin, cholesterol, hormones and drugs. Plasma proteins like albumin and clotting factors of the blood are synthesized in the liver. Viral hepatitis is classified into the following types Hepatitis A, B,C, D and E.

Causes of Hepatitis

Hepatitis A and E are generally caused by consuming contaminated water or eating contaminated food, where as Hepatitis B, C and D occur due to contact with contaminated blood and other body fluids. Hepatitis B and C are chronic forms of infection and the person remains a carrier and can pass on the disease to other through blood and body fluids like saliva, breastmilk, vaginal secretions etc.

The non viral causes of hepatitis are alcoholic hepatitis due to excessive alcohol consumption which leads to cirrhosis of liver and autoimmune diseases.

Symptoms of Hepatitis

Hepatitis presents with a wide range of symptoms that could be mild itching to severe liver failure. The following are the symptoms of acute and chronic hepatitis.

• Acute hepatitis: The onset is with a prodromal phase that is characterized by non specific symptoms like fever, malaise, nausea , vomiting, headache etc. Later on symptoms specific to liver disturbances may develop like strong yellow colored urine and clay colored stools. This is followed by yellowish discoloration of the skin and schlera of the eyes. This stage can last up to 4 weeks. The last stage is the recovery phase where the clinical symptoms begin to regress and the laboratory values of liver functions are still high. The liver is also enlarged. Hepatitis A and E are normally acute in nature and resolve fully within 1-2 months. Drug induced hepatitis and autoimmune hepatitis also present like with similar symptoms.

• Chronic Hepatitis: If the symptoms of acute hepatitis do not resolve within 6 months, it is termed as chronic hepatitis. Initially there are only non specific symptoms but gradually as the hormone metabolism in the liver gets affected, deeper symptoms come up like hirsutism and amenorrhoea. Long standing liver disease and damage to liver functions ends in cirrhosis of liver and its complications.

Diagnosis of Hepatitis

The presence of the above symptoms or a history of exposure to a contaminated persons blood will need to be investigated. The abdominal examination will reveal an enlarged liver.

The most indicative tests are blood tests called Liver function Tests which give a complete detail of the liver enzymes and proteins. If the levels are elevated, it indicates a deranged liver function. The diagnosis is normally confirmed by an ultrasound of the abdomen and viral markers that detect the presence of antibodies in the blood.

Treatment of Hepatitis

Acute types like hepatitis a and E have an infective aetiology and are usually self limiting ad the symptoms resolve. Symptomatic treatment may be required for the vomiting or diarrhea. Vaccination for Hepatitis A is mostly given to babies between 12 to 18 months and is fairly effective.

Chronic forms of hepatitis like hepatitis b resolve by treatment with antiviral drugs. Hepatitis B vaccine is recommended for all babies and health care personnel who have a risk of coming in contact with infected blood.

Hepatitis C is a chronic disease and it leads to damage to the liver and cirrhosis. Severe cases may need a hepatitis c liver transplant.

Hepatitis D is usually treated with a medicine called alpha interferon.

Hepatitis and Pregnancy

Acute viral hepatitis is a very common cause of jaundice during pregnancy and is commonly caused by intake of contaminated food and water. Jaundice is an indicator of liver disease but the type of hepatitis cannot be assessed clinically. Detailed tests may be required to isolate the type of hepatitis. The most useful tests here are the SGOT, SGPT levels. High levels of SGPT during pregnancy can be harmful to the fetus.

Hepatitis B can pass on to the unborn fetus via the blood so all pregnant women are routinely screened for hepatitis and AIDS. If a pregnant women is found to be positive, systematic vaccinations can help to protect the baby.

Hepatitis Vaccination in Infants

Hepatitis A vaccine is recommended between 12 to 18 months of age. A booster dose is given 6-18 months after the first dose.

Hepatitis B vaccine is given to babies in the first few days after birth. The first dose is given when they are still in the hospital. There are total four doses and the gap will depend on the type of the vaccine used. Children get the first dose in the first week and complete all four doses by the age of six months. The second dose is given around 1-2 months of age and the third one at six months.

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The concept of vaccination is the introduction of an antigen or pathogen into the body in order to cause antibody production and provide adaptive immunity to the individual. There are many types of vaccines. It can be inactivated where the antigen is non-ineffective in nature, it can be attenuated or at times the purified components of pathogens like the protein cover of a virus. All these work by the same mode of action and lead to the formation of antibodies in response to the foreign antigen. The first disease against which a vaccine was developed was small pox. Small pox vaccine was discovered by Edward Jenner in the year 1796 and the concept was taken further at a microbiological level by Louis Pasteur. Vaccinations are given primarily to babies and children to protect them from diseases and to stop the spread of infectious diseases like small pox and polio. Another important use of vaccines is in travelers immunization where a person travelling to a particular country needs to be vaccinated so that he does not become a carrier of any disease. With the current globalization, foreign travel vaccinations have become very common. Here we shall discuss the common vaccines for children.

Vaccination Schedule

The immunisation schedule is decided by the Indian Academy of Pediatrics (IAP) in India and in the United States by the American Academy of Pediatrics (AAP). The schedule is more or less the same with some variations.

OPV : Oral polio vaccine is a very important vaccine and has played a very vital role in the eradication of the disease. All the doses of IPV can be replaced by oral polio vaccine if the administration of the former is not possible

DPT: The dpt vaccine is for three infectious diseases diphtheria, pertussis and tetanus. There are three main doses which are given at 6 weeks, 10 weeks and 14 weeks. The common side effects include fever, excessive crying, vomiting and decreased appetite in the baby.

BCG Vaccine: Bacillus Calmette Guerin is a Tb vaccine against tuberculosis which is given on the third day after the birth of the baby. In Asian countries where the incidence of the disease is high, the vaccine is recommended to be given as close to the time of birth as possible. The injection is given intradermally and it initiates a reaction in the body and a small pustule is formed which ruptures and leaves behind a round scar. The scar is raised from the skin surface and is the proof of a prior immunization.

Rotavirus : The rotavirus vaccine is given to provide protection against rotavirus infections which are responsible for causing severe diarrhea in children. It is given at 6 and 10 weeks of age. The range is 6-8 weeks and should be given within that range. The next dose should be given one month after the first dose.

Pneumococcal vaccine: Pneumococcal conjugate vaccine (PCV) is given to children to protect children, babies and adults from diseases caused by a bacterium Streptococcus Pneumonia. It is administered at 6,10 and 14 weeks of age.

MMR: MMR vaccine is given to provide protection against measles, mumps and rubella.

Routes of Administration

There are many routes of administration of a vaccine depending on its type. The route could be oral, intradermal, intramuscular or subcutaneous. There are some recent trials  that are going on to see if vaccines could be taken up by the mucosal surfaces of the body.

Vaccinations have reduced the mortality associated with diseases and has improved the survival rate in babies who earlier died of infectious diseases.

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Congratulations on your baby’s first birthday. This week as your little baby turns one, you will see a budding personality and lots of independence. By this time, your baby 12 months old is walking or is almost ready to walk. The little bundle of joy is heading steadily towards the toddler years full of humor, talking and trying out new things. Baby development is very interesting to learn. There have been many changes in your body since you were 3 months pregnant and now that more than one year has passed, your baby has grown into an independent constantly on the move toddler.

The babbling is now taking shape into recognizable small words. Although your baby understands a lot more than he can speak at this time, he will take the help of gestures and hand movements. He is also listening to each and every word you say and will soon begin imitating those lines in the exact tone like you. Dada and mama are the words that are already there in his mini vocabulary. He also begins to associate these words with faces.

Baby 12 Months Old – Growth and Development

• Feeding: By the age of one year, you may be thinking of weaning your baby off breast milk. It is best to begin the process after the baby’s first birthday. Drop one feed at a time and if you feel that it causes unrest in your baby, then let things be and try again after another 15 days. The last feed that you should drop is the night feed as the baby will want to suck not for nutrition but also for comfort. A 1 year old baby should ideally eat all that is prepared at home and you should encourage the habit of eating with everyone by placing your child in the high chair beside the table. 1 year baby weight should be somewhere around 10-12 kg.·
• Sleep: Your baby 12 months old is sleeping through the night by now and has dropped the small day naps. He may nap once during the day and then directly at night.

How is Your Life Changing?

Your baby is getting independent day by day but still needs a lot of love and reassurance from you. There will be times when you need to go out. At all such times, try not to hide and leave the house. Instead tell your baby that you are going out and will be back very soon. When he sees you go and come back, he develops a sense of trust and the next time you go, he will not be as insecure. He may cry in the beginning but will become quite when you are gone. Leaving your baby 12 months old alone at some times will make him feel more independent.

Have some words for common requirements of your baby that both of you understand. This will help you to communicate and understand your baby’s needs better. Also if you have a caretaker, they can make use of these little words or phrases and make the child feel comfortable. Communication is very important at this stage and do not worry if you are exposing your baby to multiple languages. He will pick up more than one language during his life span and at this stage they act like a sponge and absorb whatever comes their way.

You have be extra vigilant now that your baby is one as he will pick up any small object that crosses his eyes and try to put it in the mouth or at times even up the nose. So put away pins and pointed objects and little pieces of pet food etc. If anything gets stuck in the nasal passage or throat it can be a life risk as the breathing may get obstructed and become an emergency.

Important for This Month

1. Toys: As your baby 12 months old grows, so will his games. You may want to bring out newer toys like the shape sorter or wooden puzzles and stacking the blocks. All of these will help to keep the baby busy and also improve his motor skills and fine coordination of the fingers. Giving small tasks are also very good activities for babies. There are many toys which have labels for the age group. Follow them because at times, many toys come with small parts and they can be a choking hazard. Be very careful about what you give your child to play with.
2. Dental care: This is the right time to introduce your 1 year baby to the dentist for good dental and oral care. Take him along with you for your appointments and explain what is going on. This will help to remove any fears and also mentally prepare him. Appointment with the dentist around this age is important as your baby will learn to start brushing his teeth. Now that his 12 month old meals include everything and some sweets too, it is very important to brush the teeth nicely. You can hold the baby in your arms and brush the teeth with small circular movements that are gentle. The fluoride levels in the babies toothpaste should be 1000 ppm at least. Initially your baby may resist but will gradually understand and even begin enjoying it.
3. Milk: Give your baby cows milk after he turns one. You should restrict the amount to below 500 ml as the other foods intake will tend to go down. Your one year old baby will resist as the taste and texture of the milk is different but will ultimately begin to like it. It is advisable to start with whole milk as the baby needs the calories. Cows milk is another option. Try not to put sugar in it as babies tend to get addicted to the sweet taste.
4. Pincer Grip: This month the pincer grip is developing in your baby’s fingers and he is gradually bringing the thumb and index finger together in an attempt to pick up small objects. This grip comes of help as the baby 12 months old begins picking up food and trying to feed himself. You can encourage this habit of self feeding by offering him small pieces of fruits, bread sticks or bread and biscuits. Keep them on the feeding tray and see him pick up the pieces one by one and eat them. It’s a very cute sight and you should always encourage your 1 year baby.
5. Baby Behavior: This is the age when children begin making sense of things and its uses. You child may be playing with a comb till now but somewhere around this age, he will start rubbing it on his head in the same way you do. This is nature’s way of teaching them some basic things in life. This is the most important of 1 year old milestones. The only concern here is that they will imitate everything without discrimination. If they see you taking medicines, they may give a try and pop something in their mouths. So you need to take utmost care that you keep your child under supervision. Beginning from now till the age of three, there are the chances that your little explorer may get himself into trouble by trying out new things. Poisonings with cleaning liquids and eating dangerous things are common and you need to keep a check on it.

The 12 month old milestones will vary in each child and the above are concise 1 year old development milestones. If your baby does any of these a little earlier or later, then there is nothing to worry about at all. The only thing that you need to ensure is that there should be changes happening in the right direction with each passing month. Have a great time planning your little ones first birthday and start collecting all those cute decorations. Make a list of invitees and narrow down on a color code. Happy first birthday!

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