In March 2019, Abbey learned she was pregnant. She worked with Kathryn Kersting, M.D.,  OB/GYN with Advocates for Women’s Health, a Part of Norton Women’s Care, during her entire pregnancy, including delivery. Abbey called her pregnancy “textbook,” with no issues. She knew she wanted to breastfeed, but as she did research about it, she began to feel anxious.

“I would read things, and I was like — I know I want to breastfeed, but I’m just going to wing it, and I’ll get there when I get there,” Abbey said.

Breastfeeding journey uncovers tongue-tie issue

According to Abbey, daughter Adalynn was born in November 2019 without complications, at Norton Women’s & Children’s Hospital. Abbey began her breastfeeding journey soon after. Adalynn had trouble latching on one side, so lactation consultant Natalie Brown, R.N., IBCLC, RLC, worked with Abbey to address the issue.

“She helped me learn how to use the nipple shield,” Abbey said.

Abbey went home from the hospital feeling confident about breastfeeding. However, she was experiencing a lot of pain. She had never planned to pump, as she wanted to nurse exclusively, but in talking to Adalynn’s pediatrician, they suggested that Abbey pump and offer Adalynn pumped milk afterward to see how much she would take. In doing so, Abbey said she experienced an overflow of breastmilk.

“I thought everything was fine,” Abbey said. “But I was in a lot of pain, and I thought that’s how it was supposed to be, without having done this before. Two weeks after Adalynn was born, I went to my OB to get checked, and she saw what my nipples looked like. They looked like they had holes. And she was like, ‘Oh my gosh, no! This isn’t right.’”

Abbey’s obstetrician referred her to lactation consultant Tina Martin, LPN, IBCLC, RLC. Tina performed a functional  breastfeeding assessment and weighed Adalynn before and after a feeding to see how much milk she took in. In working with Tina, Abbey learned Adalynn was experiencing breastfeeding difficulties from a posterior tongue-tie. A tongue-tie, also called ankyloglossia, is fairly common, affecting about 5% of newborns. A tongue-tie is more common in boys and frequently runs in families.

With a tongue-tie, the frenulum (stringlike tissue that attaches the tongue to the floor of the mouth) is tight, short or thick and can impede the tongue’s movement. The tongue can be  prevented from sticking out past the gums, look heart-shaped, or have difficulty  lifting up to the hard palate. A tongue-tie can pose issues for breastfeeding, because a baby may not be able to open their mouth wide or extend the tongue enough to adequately cup the breast tissue. Also, the tongue’s tightness may keep the baby from doing the necessary movement required to create a vacuum for removal of milk from the breast.

“In December, we got her tongue clipped. I remember the doctor telling me, ‘You might not notice a difference right away; it sometimes it takes a few weeks to see a difference because they’re not used to it, they have to exercise it,’” Abbey said. “At first, I didn’t notice a difference, except she kept making this clicking sound even more because she didn’t know what to do with her tongue. But soon after, she was a completely different baby, just amazing at nursing.”

In January 2020, Abbey returned to see Tina.

“She showed me exercises that I can do to help [Adalynn] figure out what to do with her tongue,” Abbey said. “And I mentioned to her that I wanted to wean off of the pump. So we talked and she told me to just cut out one pumping session at a time and go longer periods between pumping. I did that, and it took me two months to completely wean off of the pump, where I was exclusively nursing. And I got to donate 3,000 ounces that I had stored that [Adalynn] didn’t use. I was able to finally exclusively nurse without the pump, and her tongue-tie was fixed.”

While weaning off of the pump, Abbey needed extra support as she became concerned about a suspected clogged milk duct or mastitis.

“I got my first clogged duct, and I woke up at four o’clock in the morning with it, and I was freaking out thinking it was mastitis,” Abbey said. “I called my OB/GYN office’s after-hours line and I spoke to Regina Mash APRN, CNM, certified nurse midwife with Advocates for Women’s Health] for 15 or 20 minutes. She suggested that I try gravity nursing, where you kind of go over top of [the baby] and let her do it. And the clogged duct was gone within 30 minutes. I remember I talked to Tina pretty late one night because I thought that I was getting a fever or a clogged duct at one point. You can call in the middle of the night and talk to somebody if you need to, which is an amazing comfort.”

For other mothers, Abbey suggests finding out what your OB/GYN’s office offers in terms of lactation consulting.

“It was a support system for me,” Abbey said. “Everyone’s different, and some people have issues and others don’t. Know what resources there are to help you, so that if you need that help in the middle of the night, you can get it.”

Adalynn is approaching her second birthday, and according to her mother is very independent.

“She started crawling at 5 months old, and ever since then when she learned she could do things herself, she just goes,” Abbey said. “She won’t touch a bottle, so I think weaning her might pose a challenge. I’m definitely not complaining; it’s what I wanted.”

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Monitoring your health during this period is important because pregnancy can increase your risk for conditions that will build up over the years and can become life-threatening. Increased potential for stroke, cardiovascular disease and Type 2 diabetes can be traced back to pregnancy.

According to the Centers for Disease Control and Prevention (CDC), as many as 50,000 women experience severe unexpected issues because of pregnancy, and 700 women a year die as a result of pregnancy or pregnancy-related complications.

“Women can have complications from childbirth up to a year after delivery,” said Lyndsey D. Neese, M.D., obstetrician and medical director of quality for women’s services at Norton Healthcare. “Women also can experience long-term health consequences related to their pregnancy.”

For women who experience preterm delivery, gestational diabetes, hypertension or preeclampsia during pregnancy, there is a greater risk for arteriosclerotic cardiovascular disease. The build-up of fats, cholesterol and other substances in and on the artery walls can break free into the bloodstream, causing strokes and heart attacks.

A study by researchers at the Johns Hopkins Bloomberg School of Public Health found that around 40% of women did not attend a visit with their medical provider after childbirth.

“It’s incredibly important that women attend their postpartum visit with their medical provider,” Dr. Neese said. “We actually call this the ‘fourth trimester,’ and during this visit we can look at any potential issues and set up additional exams as needed.”

Postpartum complications to watch for

The CDC’s Hear Her campaign lists symptoms women and their families should look for up to a year after childbirth:

• Severe headache that won’t go away or gets worse
• Dizziness and/or fainting
• Vision changes such as seeing spots or blurred vision
• Fever over 100.4 degrees Fahrenheit
• Swelling in hands that makes it hard for you to bend fingers; swelling in face that makes it hard to open your eyes or your lips and mouth are swollen
• Swelling or pain in your leg that may be red, swollen or warm. You may or may not be able to stand or walk.
• Thinking about hurting yourself or your baby
• Trouble breathing or tightness in chest and/or throat
• Chest pain in the center of your chest or that travels to your back, neck or arm
• Fast heartbeat
• Throwing up (more than you would during morning sickness) and unable to drink anything for more than eight hours or eat anything for more than 24 hours
• Sharp and/or sudden stomach pain that gets worse or doesn’t go away
• Vaginal bleeding or discharge
• Extreme tiredness that may come on suddenly

The post Unexpected health issues after pregnancy can have long-term consequences appeared first on Norton Healthcare.

Just in time for National Breastfeeding Month, Baby Bistro & Boutique is marking its fifth anniversary of providing advice, supplies and support to breastfeeding moms.

Moms and their families can buy and rent breast pumps and parts, breastfeeding bras, breastfeeding pillows and many other breastfeeding supplies. Mothers also can make an appointment with a lactation consultant for one-on-one assistance with any issues they’re having breastfeeding.

To ensure safe access to breastfeeding supplies and lactation consulting services during the coronavirus outbreak, we have modified our operations at Baby Bistro & Boutique on the Norton Healthcare – St. Matthews campus. Now you can prepay for your items over the phone with your credit card and wait in your vehicle outside the store, and we will bring them out to you. To rent a hospital-grade breast pump, call (502) 899-6530. Baby Bistro & Boutique is open Monday through Friday, 8 a.m. to noon and 1 to 4 p.m.

What makes Baby Bistro & Boutique special

• Convenient one-stop shopping for breast pumps and parts, breastfeeding bras, nursing pillows and many other items that make life easier for breastfeeding moms
• Certified lactation consultant available by appointment to answer questions and teach new moms to use breast-pumping equipment
• Breastfeeding services, including individual counseling, breast milk analysis to determine fat and calorie content, and follow-up for infants having trouble gaining weight
• Services for moms with special needs, such as feeding multiples, hearing impairment, vision impairment or needing interpreter services
• Services for babies with special needs

Outpatient lactation services for moms and babies who need extra help

Here’s what you need to know about making an appointment with our certified lactation consultant:

• You will need to request from your physician an appointment to see the lactation consultant to address any issues you may be having with breastfeeding.
• Arrive with your baby 15 minutes before your appointment to register.
• From Dutchmans Lane, take Entrance 3 to Norton Healthcare – St. Matthews campus.
• Pull up to the doors marked Labor and Delivery (Norton Medical Plaza 3 – St. Matthews).
• Enter and proceed straight ahead to the elevators.
• Take an elevator to the second floor to the Labor and Delivery waiting room.
• Register for a lactation services (breastfeeding) visit at the Labor and Delivery registration desk.
• Return to the first floor and follow the signs to the Baby Bistro & Boutique. It will be on your right off the elevator and past the information desk.
• Enter and tell the clerk that you have an appointment for lactation services.
• If the Baby Bistro & Boutique is closed, call (502) 559-1733 and wait by the information desk.

The post Baby Bistro & Boutique celebrates milestone in offering breastfeeding supplies and help appeared first on Norton Healthcare.

“Soreness in the vaginal area usually will begin to ease over six to 12 weeks after birth,” said Kenneth J. Payne, M.D., OB/GYN with Norton OB/GYN Associates. “Change your pads promptly and often. Be extra careful to wash your hands before and after to reduce the chance of infection. If you have concerns, please contact your provider.”

To ease discomfort while you’re healing:

• Soak in warm water a few times per day. This can be in a tub or a sitz bath — a round, shallow basin that fits over the toilet seat. Warm water alone will boost the blood flow around the affected area, promoting healing.

If approved by your provider, Epsom salts, witch hazel, vinegar or baking soda can be added to the water to reduce itching and inhibit bacterial growth.

• Sit on a pillow or padded ring.
• Take any nonsteroidal medications, such as ibuprofen, as prescribed by your provider.
• Use a squeeze bottle to pour warm water on your perineum after you urinate.
• Placing a chilled witch hazel pad between a pad and the wound will decrease discomfort.
• Talk to your doctor about using over-the-counter pain relievers, or a numbing spray  (Dermoplast).

The post Soothing postpartum vaginal soreness appeared first on Norton Healthcare.

Waiting at least six weeks after childbirth to have sexual intercourse is best. You’ll need to get clearance from your provider, because there are risks to having sexual intercourse too soon after giving birth.

Having sex too soon increases the risk of hemorrhage and uterine infection. A cesarean section is major surgery, and your body will need at least six weeks — and likely eight weeks — to heal.

Give your body time to heal after giving birth

Any vaginal tears, especially those repaired surgically, will need time to heal. Regardless of the time frame, you should wait until postpartum discharge has stopped before resuming sexual intercourse.

Postpartum discharge typically lasts about two weeks and is initially mostly bleeding from the area where the placenta detached from the uterus. It also contains tissue from the uterus, as well as bacteria.

It’s quite normal to be fatigued and to experience vaginal dryness, pain and low sexual desire after giving birth.

Be alert to insomnia, severe mood swings, loss of appetite, overwhelming fatigue and a loss of interest or pleasure. These could be signs of postpartum depression. Contact your provider if you experience these symptoms.

The post How long after giving birth can you have sex? appeared first on Norton Healthcare.

Worrying about a new baby is normal. Is she eating enough? Is he sleeping too much? Germs!

And you’re not going to get enough sleep.

Does the worry consume you? Are you able to sleep when baby sleeps? Are you having panic attacks? Are you fearful something will happen to baby? Do disturbing images pop in your mind?

It’s important not to dismiss postpartum anxiety symptoms or confuse them with the slew of changes your body goes through after birth.

If you feel you are having anxiety-related symptoms that are causing you difficulty, this may be postpartum anxiety.

“Having a baby is a time of transition. Some situational anxiety is not uncommon,” said Amanda B. Hettinger, M.D., psychiatrist with Norton Women’s Mental Health Services. “However, if this is causing more disruption in your daily activities and does not feel like it is getting better, I would highly recommend being evaluated. Treatment can be very helpful.”

Postpartum anxiety symptoms can include:

• Constant worry or nervousness
• Insomnia and fatigue
• Extreme attention to the baby
• Disrupted appetite
• Dizziness, hot flashes, vomiting or nausea
• Thoughts of catastrophic events or worry regarding the future
• Distraction; inability to concentrate

New moms who have previously experienced mental health symptoms may notice their symptoms worsen after delivery. New anxiety-related symptoms after childbirth could include panic disorder, generalized anxiety disorder, obsessive-compulsive disorder and post-traumatic stress disorder.

The post Postpartum anxiety is different from depression: Watch for symptoms appeared first on Norton Healthcare.

With the right preparation and support, you don’t have to give up your breastfeeding goals when you go back to work.

Most working mothers go back to work six to eight weeks after having a baby, so most working breastfeeding mothers will have to pump at work. Pumping and working can be challenging, but planning ahead will help you be successful.

Plan During Pregnancy

Don’t wait until you are ready to head back to work to start thinking about your breastfeeding plan. Consider these tips before your baby arrives:

1. Create a breastfeeding plan with your boss: Talk to your manager about your proposed breastfeeding plan, including where you plan to pump, where you plan to store your milk, and the number and duration of breaks you’ll need for pumping during work hours. Get your manager’s approval before your maternity leave.
2. Locate your child care options: Investigate child care options to determine if any are close enough that you can breastfeed on longer breaks. Ask if the facility can store and use your pumped breast milk to feed your baby during the work day.
3. Practice makes perfect: Get a quality electric breast pump and practice expressing milk before returning to work. Contact a lactation consultant, your health care provider, WIC program or a public health department if you have difficulties pumping or have questions.

Returning to Work

Eliminate the anxiety of returning to work by following these simple tips from moms who have made a successful transition back into the workforce:

1. Ask questions: Find a strong support system of women who have been there before. Talk to your friends and family to learn from their experiences with breastfeeding and working. Ask co-workers about their experiences pumping at work.
2. Locate a lactation space: Map out the quickest route to and from where you plan to pump. Make sure the door locks and provides enough space.
3. Evaluate your lactation plan: After a few weeks of using your lactation plan created with your manager, take a look at how it is going. Discuss any changes that need to be made.

Pumping Schedule

Creating a pumping routine is the key to a successful transition to work. Most moms will need to use their morning and afternoon break times and part of their lunch break to pump. If you don’t have usual break times, talk to your supervisor about scheduling times for this process.

“Currently any business with 50 or more employees must provide a private place to pump — not a bathroom — as well as sufficient break time to pump,” said Elizabeth M. Doyle, M.D., pediatrician with Norton Community Medical Associates – Shepherdsville and Norton Healthcare’s system medical director for lactation.

With a double-sided electric pump, each pumping session will take about 15 to 20 minutes; however, some women might pump for a longer or shorter time. You also will need time to get to and from the lactation space and to wash your hands and equipment. A hands-free pumping bra allows you the flexibility to eat or drink, answer emails or just play a game to pass the time.

Sample pumping schedule for eight-hour work day — first six months

Sample pumping schedule for 12-hour work day if doing first and last feedings at home – first 6 months

The post Breastfeeding and ready to go back to work? Here are some tips appeared first on Norton Healthcare.

It’s a fair question. After all, it’s not like you’re using a bottle with ounces marked clearly on the side that let you see exactly how much milk your baby takes in with each feeding.

Elizabeth M. Doyle, M.D., Norton Children’s Medical Associates – Shepherdsville and Norton Healthcare’s system medical director for lactation, offers these useful guidelines to help moms know when their babies are getting enough nutrition and liquids from breastfeeding:

• Baby is feeding a minimum of eight times per day; optimal is 10 to 12 times per day.
• Infant is active and alert.
• Infant actively feeds at breast, with sucking and swallowing for at least 10 minutes.
• Baby is producing seven to eight wet diapers per day.
• Baby has met the general “4-by-4” goal to produce four stools by day four of life.
• Breasts feel full before feeding and empty afterward.

Dr. Doyle reminds moms — especially new moms — that breastfeeding can look and work differently for every mom and baby.

“Never be shy about asking questions when it comes to your baby’s well-being,” she said. “If you think something isn’t right with your baby, call your pediatrician!  You know your baby best.”

The post What are the signs baby isn’t getting enough breast milk? appeared first on Norton Healthcare.

If you have a MyNortonChart account, you have access to free, face-to-face secure video visits with a provider for breastfeeding help any time of the day or night.

“While breastfeeding is a natural part of motherhood for many, first-time moms as well as experienced mothers sometimes need a little extra help,” said Elizabeth Doyle, M.D., pediatrician with Norton Community Medical Associates – Shepherdsville and Norton Healthcare’s system medical director for lactation. “Anyone who wishes to breastfeed is welcome to use the service.”

Kentucky breastfeeding rates lag nation

Nearly 74 percent of mothers in Kentucky have breastfed at some point. That’s an increase for the state, but is still lower than the national average of 83.2 percent.

Breastfeeding has many benefits. It can reduce ear infections, pneumonia, diarrhea/vomiting and sudden infant death syndrome. It also decreases a mother’s risk of breast and ovarian cancers, as well as diabetes, high blood pressure and heart disease.

“We hope that providing this service can help more mothers try to breastfeed — and keep breastfeeding as long as possible,” Dr. Doyle said.

A Norton eCare video visit can help with questions or concerns about:

• Latch and positioning
• Mastitis
• Clogged ducts
• Engorgement
• Pumping issues
• Milk storage
• Weaning
• Medications

The post Free breastfeeding support for moms appeared first on Norton Healthcare.

Elizabeth Doyle, M.D., physician with Norton Community Medical Associates – Shepherdsville and Norton Healthcare’s system medical director for lactation, weighed in on the discussion and other breastfeeding topics.

Q: This new study notes that infants who are exclusively breastfed do not sleep as well as those who are given solid food earlier. Should parents be giving solid food to their babies earlier?

A: There are more negative implications that come with starting an infant on solid food earlier. It is not “normal” to sleep through the night for breastfed infants, especially in the months right after birth. In fact, some breastfed babies do not sleep through the night until they are 1 year old. Breast milk is more easily digested than formula and does not sit in the stomach for as long. It is common and normal for breastfed infants to wake in the night for necessary feedings throughout the first year. The study in question found that babies on earlier solids (at 3 months old) only slept for up to 16 minutes longer per night. There also is a study that links feeding solid foods to babies before 4 month old to an increased risk of Type 1 diabetes (insulin-requiring).

Q: Why should solid foods be avoided the first six months?

A: An infant must be able to sit up to consume solid food, however the majority of infants cannot sit up until about 6 months of age. Mothers should strive to exclusively breastfeed their child for the first four to six months. Breastfeeding is species-specific and has health benefits from baby and mother. It reduces infections in babies, such as ear infections, diarrhea and pneumonia. It is not only healthier, but also reduces a mother’s risk of diabetes, heart disease and breast cancer. Because pregnancy is a high-sugar/high-fat metabolic state, the act of breastfeeding returns the mother’s metabolism to normal. In addition, infants might not be ready until closer to six months to actually swallow foods. The tongue motions for sucking from the breast or the bottle are completely different than motions required to swallow baby food.

Q: Why is breastfeeding so important for children?

A: Breastmilk is uniquely engineered for each baby, at that moment. Breastfeeding can help with the following:

• • Decreases risk of common childhood infections such as vomiting/diarrhea, common cold, ear infections
  • Decreases risk of more severe childhood infections, such as pneumonia and hospitalizations for dehydration
  • Decreases risk of sudden infant death syndrome (SIDS) by 75 percent
  • Reduce the child’s risk of developing diabetes

Q: With all the outbreak of hepatitis A, should new moms stop breastfeeding if they get vaccinated?

A: It is completely safe for breastfeeding mothers to get a hepatitis A shot. Many mothers worry that receiving a vaccine and then breastfeeding will negatively impact their child. This is not the case. Babies are not able to get the vaccine for hepatitis A until age 1, so getting a hepatitis A vaccine can protect you and your child.

Q: What’s the biggest thing you want parents to know?

A: There’s not a one-size-fits-all approach for every situation. If you have questions, talk to your child’s pediatrician. Your pediatrician will be able to give you suggestions to help you find the optimal time to start your baby on solid foods.

The post Does solid food over breastfeeding really help babies sleep better? appeared first on Norton Healthcare.