Category Archives: Baby Your Baby

Flu and pregnancy



When you’re pregnant, you’re more at risk for getting the flu. And the flu can have serious effects on both mom and baby.

Jade Elliott spoke with  Celeste Thomas, a certified nurse midwife with Intermountain Healthcare, about the risks for pregnant women during flu season and how you can protect yourself on this episode of the Baby Your Baby Podcast.

Why pregnant women are more susceptible to the flu

When you’re pregnant, changes occur in your immune system and it is naturally suppressed, making you more susceptible to the flu. Also, your lung capacity decreases and heart rate increases, during pregnancy, putting additional stress on the heart and lungs.

All three of these things make pregnant women (and women up to two weeks postpartum)

more prone to severe illness or hospitalization from the flu.

Why the flu can be serious for pregnant women and their unborn baby

Pregnant women who have the flu are:

  • More likely to be hospitalized
  •  At higher risk of pregnancy complications, such as preterm labor and preterm birth.
  • At risk of having a baby with neural tube birth defects or other adverse outcomes due to fever.

Flu vaccines are safe and recommended for pregnant women

Getting a flu vaccine is the first and most important step in protecting against flu and helps protect both the mother and her baby from the flu. The vaccine protects babies from the flu for the first several months after their birth because the mom passes antibodies onto the developing baby. Once babies are six months or older, they can get their own vaccine.

Flu shots have been given to millions of pregnant women over many years with a good safety record. There is a lot of evidence that flu vaccines can be given safely during pregnancy. Pregnant women can get vaccinated during any trimester of their pregnancy. Getting a flu shot at the beginning of flu season (October) is recommended. It takes about two weeks for the body to build up protective antibodies after you get the flu shot.

Pregnant women should not get the nasal spray flu vaccine, as it contains a live strain of the virus.

Vaccination has been shown to reduce the risk of flu-associated acute respiratory infection in pregnant women by up to one-half. A 2018 study showed that getting a flu shot reduced a pregnant woman’s risk of being hospitalized with flu by an average of 40 percent.

What else can I do to stop the spread of disease?

The same prevention methods work for flu or COVID-19

  • Get a seasonal flu vaccine. Everyone in the family (over the age of 6 months) should get a vaccine, and so should anyone who cares for your baby.
  •  Wear a mask, being sure it covers your nose and mouth snuggly.
  • Wash your hands often and well, and have children do the same.
  •  If you’re sick, stay home from school or work.
  • Avoid close contact with people who are sick, if possible.
  • Cover your sneezes and coughs.
  • Use a tissue once, then throw it away and wash your hands.

Signs and symptoms of the flu

Seasonal flu symptoms usually come on fast, causing chills, fever, muscle aches, tiredness, dry cough, and sore throat. Occasionally, seasonal flu will cause a runny or stuffy nose or, in young children, nausea, vomiting, and diarrhea.

How influenza spreads

The flu virus prefers air travel, catching rides on the tiny droplets that fly out when someone sneezes or coughs. However, it can also stick around on surfaces for a while. If you touch something that was recently contaminated and then touch your mouth or nose, you can get infected, too. It is important to note you can spread the virus before you show signs of illness.

What if I get the flu during pregnancy?

If you begin feeling ill with any of the symptoms of the flu, or feel you may have it, contact your doctor immediately. Your doctor can prescribe you safe antiviral medications to treat the flu. Taking antiviral medications as soon as you find out you are sick can reduce the amount of time you are sick. Other steps to treat the flu include getting plenty of rest and drinking plenty of fluids. Talk with your doctor before taking any over the counter medications for the flu.

For more information

Ask your doctor about getting a flu vaccine. Or for locations to receive the flu vaccine, go to intermountainhealthcare.org/flu

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


Food allergies and kids



Food allergies can cause serious and even deadly reactions in kids, so it’s important to know how to feed a child with food allergies and to prevent reactions.

Jade Elliott spoke with Dr. Thad Abbott, Intermountain Healthcare, on this episode of the Baby Your Baby Podcast about how food allergies effect kids and how to manage them while they are at school.

What Are Food Allergies?

Milk, eggs, soy, wheat, tree nuts, peanuts, fish, and shellfish are among the most common foods that cause allergies.

Food allergies can cause serious and even deadly reactions. So it’s important to know how to recognize an allergic reaction and to be prepared if one happens.

What Are the Signs & Symptoms of a Food Allergy?

With a food allergy, the body reacts as though that particular food product is harmful. As a result, the body’s immune system (which fights infection and disease) creates antibodies to fight the food allergen .

Every time the person eats (or, in some cases, handles or breathes in) the food, the body releases chemicals like histamine . This triggers allergic symptoms that can affect the respiratory system, gastrointestinal tract, skin, or cardiovascular system.

Symptoms can include:

  • wheezing
  • trouble breathing
  • coughing
  • hoarseness
  • throat tightness
  • belly pain
  • vomiting
  • diarrhea
  • itchy, watery, or swollen eyes
  • hives
  • red spots
  • swelling
  • a drop in blood pressure, causing lightheadedness or loss of consciousness (passing out)

What Are the Most Common Food Allergens?

A child could be allergic to any food, but these eight common allergens account for 90% of all reactions in kids:

  • milk
  • eggs
  • peanuts
  • soy
  • wheat
  • tree nuts (such as walnuts and cashews)
  • fish
  • shellfish (such as shrimp)

In general, most kids with food allergies outgrow them. Of those who are allergic to milk, about 80% will eventually outgrow the allergy. About two-thirds with allergies to eggs and about 80% with a wheat or soy allergy will outgrow those by the time they’re 5 years old. Other food allergies may be harder to outgrow.

What Happens in a Food Allergy Reaction?

Food allergy reactions can vary from person to person. Sometimes the same person can react differently at different times. So it’s very important to quickly identify and treat food allergy reactions.

Reactions can:

  • be very mild and only involve one part of the body, like hives on the skin
  • be more severe and involve more than one part of the body
  • happen within a few minutes or up to 2 hours after contact with the food
  • Food allergy reactions can affect any of these four areas of the body:
  • skin: itchy red bumps (hives); eczema; redness and swelling of the face or extremities; itching and swelling of the lips, tongue, or mouth (skin reactions are the most common type of reaction)
  • gastrointestinal tract: belly pain, nausea, vomiting, or diarrhea
  • respiratory system: runny or stuffy nose, sneezing, coughing, wheezing, shortness of breath
  • cardiovascular system: lightheadedness or fainting

Sometimes, an allergy can cause a severe reaction called anaphylaxis, even if a previous reaction was mild. Anaphylaxis might start with some of the same symptoms as a less severe reaction, but can quickly get worse. The person may have trouble breathing or pass out. More than one part of the body might be involved. If it isn’t treated, anaphylaxis can be life-threatening.

How Are Food Allergies Treated?

If your child has a food allergy, the allergist will help you create a treatment plan. Treatment usually means avoiding the allergen and all the foods that contain it.

You’ll need to read food labels so you can avoid the allergen. Makers of foods sold in the United States must state whether foods contain any of the top eight most common allergens: milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, or soy.

There’s no cure for food allergies. But medicines can treat both minor and severe symptoms. Antihistamines might be used to treat symptoms such as hives, runny nose, or belly pain from an allergic reaction.

If your child has any kind of serious food allergy, the doctor will want him or her to carry an epinephrine auto-injector in case of an emergency.

An epinephrine auto-injector is a prescription medicine that comes in a small, easy-to-carry container. It’s easy to use. Your doctor will show you how. Kids who are old enough can be taught how to give themselves the injection. If they carry the epinephrine, it should be nearby, not left in a locker or in the nurse’s office.

Signs and symptoms of anaphylaxis that would require epinephrine include:

  • hoarseness
  • throat feels tight
  • swelling in the mouth
  • trouble breathing
  • any symptoms from two or more body systems (skin, heart, lungs, etc.), such as hives and belly pain
  • any other combination of two or more symptoms that affect different parts of the body

Every second counts in an allergic reaction. If your child starts having serious allergic symptoms, give the epinephrine auto-injector right away. Also give it right away if the symptoms involve two different parts of the body, like hives with vomiting. Then call 911 and take your child to the emergency room. Your child needs to be under medical supervision because even if the worst seems to have passed, a second wave of serious symptoms can happen.

It’s also a good idea to carry an over-the-counter (OTC) antihistamine for your child, as this can help treat mild allergy symptoms. Use antihistamines after — not as a replacement for — the epinephrine shot during life-threatening reactions.

For more information, click here.

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


How to know if your baby is hearing properly



When you have a new baby, many new moms have a lot of questions about what is normal and healthy for babies. Since babies can’t talk, you are left wondering what your baby needs and if he or she is developing properly.

That’s why taking your baby to all of their well-child check-ups with their pediatrician is so important.

Jade Elliott spoke with Dr. Jenna Whitman, a pediatrician with Intermountain Healthcare  about how going to those check-ups can help you get your questions answered and help you learn about the screenings and immunizations offered at those appointments and how they will help you keep your baby and your household healthy, which is so important during the COVID-19 pandemic and also as we approach cold, flu and respiratory season.

How pediatricians are keeping children and parents safe from viruses when they come in for a well-check

Medical providers for children around the state of Utah have largely adopted practices suggested by the American Academy of Pediatrics that minimize risk of COVID-19 exposure and allow for the delivery of services to newborns and young children.

According to the Centers for Disease Control, these strategies include ways to separate children who are sick from children who come for well-child checkups such as:

• Scheduling well visits in the morning and sick visits in the afternoon.

• Separating patients spatially, such as by placing patients with sick visits in different areas of the clinic or another location from patients with well visits.

Many clinics are using other innovative strategies as well, such as check-ins from cars and expedited rooming, avoiding waiting rooms altogether. Ask your provider about the precautions they’re taking.

Well-check visits are just as important for healthy children as for sick children

At each check up your child’s doctor will cover many things including:

• Immunizations. Your child will receive immunizations recommended by your doctor and according to a suggested schedule for babies and children to help prevent common childhood diseases.

• Flu shots are recommended annually for healthy children over age six months. With all the uncertainties surrounding the current COVID pandemic, keeping children healthy by getting their flu shots has never been more important. Many parents focus on getting the immunizations required for day care or school. But, don’t forget to come back after school starts for a flu shot. Typically, they’re available by October.

• Tips for nutrition, child safety and how to keep your child healthy.

• Tracking growth and development. You can discuss your child’s physical growth and also if they’re reaching developmental milestones. You’ll also go over what social behaviors and learning to expect at every age.

• New health concerns. Your child’s check up is an excellent time to bring up any new concerns you may have about how your child.

Regular visits help create strong, trustworthy life-long relationships among pediatrician, parent and child.

How to Know if Your Baby is Hearing Properly

In the U.S. hearing screenings are typically done at the hospital after a baby is born, before they go home. 1 to 3 of every 1,000 babies born in the U.S. have hearing levels outside the typical range.

The American Academy of Pediatrics (AAP) recommends hearing screenings for all newborns. The goal is for all babies to have a newborn hearing screening by one month of age, ideally before they go home from the hospital; identified by 3 months of age and enrolled in early intervention or treatment, if identified as deaf or hard of hearing, by the age of 6 months.

Your child’s pediatrician will decide if they need any further tests of their hearing. If you have concerns about how your child is hearing or responding to your voice, please bring up these concerns with your doctor.

What to watch for at home to check hearing

Even the youngest infants should respond to your voice. You can watch how your baby responds to sounds and your voice. At birth babies should move their eyes in response to sound. As they get older they will start to turn their heads in response to their audio cues. Your child’s speech development is also related to their hearing. Your pediatrician will follow this development as your baby learns new words and begins forming sentences and can refer you to a speech therapist if needed.

Signs of hearing loss

Talk to your pediatrician if you notice your baby

• Doesn’t startle at loud noises by one month old or turn toward sounds by 3-4 months.

• Doesn’t notice you until he sees you.

• Concentrates on vibrating noises more than other types of sounds.

• Doesn’t seem to enjoy being read to.

• Is slow to begin talking, hard to understand, or doesn’t say single words such as “dada” or “mama” by 12 to 15 months of age.

• Doesn’t always respond when called, especially from another room.

• Seems to hear some sounds but not others.

• Has trouble holding his or her head steady or is slow to sit or walk unsupported.

If your pediatrician thinks your child needs additional hearing screenings, they can refer you to hearing specialists that see children or the audiology services available through Primary Children’s Hospital. For more information click here.

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


How and when to wean your baby



Just as it’s a personal decision about whether to breastfeed, deciding when to wean your baby or stop breastfeeding is also a personal decision.

Jade Elliott spoke with Michele Carnesecca, a registered nurse and certified lactation consultant with Intermountain Healthcare,  about how and when to wean your baby.

How long to breastfeed

As for how long to breastfeed, the recommendations vary. The American Academy of Pediatrics recommends women breastfeed their baby exclusively for the first six months and then continue breastfeeding until 12 months of age. The World Health Organization (WHO) recommends babies breastfeed exclusively for six months, and then continue breastfeeding until age two years and beyond.

Benefits of breastfeeding

Breastfeeding has many benefits for babies and also for moms. The antibodies in breastmilk help protect babies from illness. Breastmilk has just the right amount of fat, sugar, water, and protein to help your baby continue to grow.

Breast feeding is also a great benefit to the environment and society. Breastfeeding families are sick less often and parents miss less work. Breastfeeding does not require the use of energy for manufacturing or create waste. There is no risk of contamination and it is always at the right temperature and ready to feed. As long as you breastfeed, you and your baby will reap those benefits.

Some reasons you may want to or need to wean your baby

Sometimes women may need to wean their baby or they may choose to wean their baby. Talk with a lactation consultant, and ask about what options you might consider. Some reasons moms may start to think about weaning might be:

1. Returning to work. Often you can still breastfeed after returning to work, by pumping milk when you’re away from your baby. Current U.S. laws (“Break Time for Nursing Mothers Law”) require employers to allow the time and a place for pumping milk.

2. Concern about taking medications that would transfer into breastmilk. Most medications are safe to take while breastfeeding. Ask your doctor or pharmacist if the medication you’re taking is safe for your baby.

3. Traumatic circumstances may mean you need to stop breastfeeding, such as when you have a stillborn baby or a baby that dies as an infant.

4. Medical concerns. If you or your baby needs to receive medical treatment and are concerned about if you can continue to breastfeed, talk to your doctor or a lactation consultant. If you have a baby in the Neonatal ICU, you can pump your milk. Breastmilk is especially beneficial for preemies.

When to wean your baby

Sometimes your baby will lead the weaning. Or sometimes mom can lead the weaning. But the best way to wean is to do it gradually. Abrupt weaning is hard for baby and for mom. Here are some ways start weaning gradually.

Weaning before six months is harder than when your baby is older. If your baby is eating solid food, they will gradually become less interested in nursing.

Wean your baby gradually

There are different methods to wean your baby. The latest information on weaning states that a mom should wean gradually to help avoid trauma to the infant, avoid a breast infection (mastitis) and to make it more comfortable for the mom.

How to wean your baby

1. Baby lead weaning. Don’t offer to nurse your baby, but don’t refuse if your baby wants to nurse.

2. Drop one feeding at a time. Start with the feeding your baby will miss the least or their least favorite time for feeding. You can drop one more feeding per day about every 3-7 days. If you drop about one feeding per week, your milk supply will decrease gradually, which is more comfortable for you and then your baby can adjust gradually too.

Challenges with weaning

Sometimes a baby is difficult to wean. You can use distraction, and do another favorite activity with your baby at the time you’d usually nurse.

You might have to change locations or avoid the place where you usually nurse.

Plugged milk ducts or mastitis can occur if you don’t wean gradually. If you get a plugged milk duct or lump in your breast, massage it while you are feeding or pumping. The shower is a great place to work out a plugged milk duct. Mastitis is a breast infection. Symptoms include a fever, redness, swelling and pain in the breast. Treatment includes frequent milk removal, rest and lots of fluids. Some ways to prevent mastitis are to pump or hand express milk if your breasts are too full. Use a cold compress if you have mastitis or pain in your breasts. You can use a bag of frozen vegetables as a cold compress. Don’t place ice directly on the skin. Ibuprofen can help with pain or swelling.

Emotions surrounding weaning

Some mothers feel a deep sadness when they wean because it means their baby is moving on to another stage of life. These feelings are normal. Make sure you give extra love, hugs, and attention to your baby as they wean. You can start new habits like playing or reading a book together.

If you have to wean your baby and you’re not ready, you may feel anger and sadness. This is normal.

When you wean your baby you may also feel a little more freedom. Weaning means you’re free to leave your baby for longer periods of time if you have someone you trust who can watch your baby.

If you’ve had to wean your baby due to a traumatic experience, such as a loss of your baby, you can pump your milk and donate it for other babies. Many Intermountain hospitals are donation sites for donations for the Mountain West Mother’s Milk Bank.

For more information click here.

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


Postpartum pain management: five simple ways to relieve pain after childbirth



When you’re pregnant and you think about delivering your baby, you might worry about the pain during childbirth. But many women might not think too much about the pain that can continue after childbirth. Right after you have a baby, whether you’ve had a regular vaginal delivery or if you’ve had a Caesarean section, which requires abdominal surgery, women typically feel very tired and pretty sore for a few days.

Jade Elliott spoke with Kim Compagni, a pharmacist and executive operations director of pain management services for Intermountain Healthcare and Amy Campbell, a nurse and the Interim executive director for the women’s health clinical program at Intermountain Healthcare,  about the things you can do to manage the pain after childbirth,

How does the pain after childbirth vary depending on the kind of delivery you have? What’s typical for a vaginal delivery?

Uterine cramping is the most common pain women experience after childbirth. The body releases oxytocin after your baby is born to begin the process of shrinking the uterus back to its pre-pregnancy size. There is also pain as the uterus begins to contract and tighten back up. This also slows post-partum bleeding. This cramping pain may also increase during breastfeeding. Uterine cramping is typically described as dull, aching pain. Women typically also have perineum pain and some swelling. Most women describe it as a stinging type pain, sometimes throbbing pain. It’s common to have pain in the vaginal wall from an episiotomy or tearing of the perineum.

And what about if you have complications like delivering by Caesarean section, how can that affect your pain level?

Uterine cramping is normal after a Caesarean section as well. A C-section procedure is done by making a horizonal incision just above the pubic bone. The pain from a C-Section is incisional pain or surgical pain in that lower abdominal muscle. Women describe this as stinging, throbbing or sharp shooting pain.

How does pain tolerance vary from woman to woman?

Pain tolerance varies from person to person. Every woman is different and the trauma to the mother’s body varies during every birth. Typically, when it’s a second or subsequent birth, women have more cramping and after pains. Pain varies from woman to woman by her ability to cope and her endurance for pain as well. Rest is so important to improve pain tolerance. Many women have adopted the practice of meditation and hypnosis to prepare for the birth experience, and these same methods can be used after birth. Pain tolerance can be improved greatly with these practices.

In childbirth, the amount of after pains depend on if it’s your first birth. Typically, when it’s a second or subsequent birth, women have more cramping and after pains.

What should new moms know about alleviating pain after childbirth?

Pain is part of childbirth. It’s normal. Have realistic expectations afterward. Talk to your doctor, midwife and pharmacist to help determine if you might need pain control after childbirth.

Your postpartum nurses can help teach you simple ways to help alleviate postpartum pain. Positioning your body is important. You can use pillows for your back, or under your arms or knees. Ice packs placed on your perineal area or Caesarean incision are very helpful. Witch hazel pads help both soothe perineal pain and keep the area clean. Lidocaine spray or gel can be applied for instant topical pain relief.

5 Simple Ways to Relieve Pain After Childbirth

  1. Use ice packs for soreness
  2. Apply topical Lidocaine spray or gel
  3. Use witch hazel pads to soothe and clean the perineal area
  4.  Use over the counter pain relievers like ibuprofen
  5.  For complications, use non-opioid prescription pain relievers.

What types of pain relief may be used?

The key to pain management is to take scheduled acetaminophen and Ibuprofen around the clock for 2-3 days postpartum. The scheduled doses of medications will allow for an opioid free postpartum period. Rotate every 3-4 hours taking 1000 mg acetaminophen and alternating with 600 mg of ibuprofen. Ibuprofen also reduces swelling. You should only rarely need an opioid after childbirth and usually only for one to two days.

After childbirth is a time period where constipation can be troublesome, and opioids compound the problem. Taking stool softeners, drinking plenty of fluids and getting a short walk in each day can alleviate the constipation.

Over the counter topical medications such as dibucaine ointment and witch hazel can provide some additional pain relief and can help with swelling. We want women to be comfortable, so discuss on-going pain issues with your provider.

Why might postpartum women be at risk for becoming addicted to prescription pain relievers?

Childbirth is difficult. You’re tired, you’re in pain, especially with a c-section. Your hormones are fluctuating. It’s a big life change and adjustment. The combination of all those things could lead to postpartum depression, anxiety or addiction.

In the past, opioids were a common solution for pain. But now, we know more of the risks about opioids and about many opioid alternatives.

Are opioids safe for your baby if you plan to breastfeed?

When you’re nursing, medications can end up in your breastmilk and affect your baby. Check with your provider or pharmacist about what medications are safe when breastfeeding. If opioids are used by the mother, the infant should be monitored for sedation and respiratory depression. Withdrawal symptoms can occur in breast-fed infants when moms stop taking an opioid or when breast-feeding is stopped.

Is it safe for moms to take opioids short term after delivery?

In recent years, we’ve become much more aware of the risks of prescription opioids and opioid addiction. We recommend not taking opioids for more than three days after childbirth. If you have an opioid prescription and it says you can take it every four hours, you don’t need to take it every four hours. As your pain lessens, you should cut back the dose and frequency.

Why is it good to avoid opioids?

A side effect of opioids is drowsiness. Women have oxytocin in their body naturally after delivery and that makes you tired. So those things combined, can make it hard to take care of your baby. Your baby needs your full attention.

Opioids can be highly addictive. Taking opioids can lead to addiction, which can lead to other problems that could interfere with your ability to take care of your baby or family, maintain relationships, make good decisions, keep yourself and your baby safe, go to work or school or achieve your goals.

What is the potential for opioid addiction?

Physical dependence typically takes about seven days. The likelihood of developing opioid use disorder increases with time and dose. That is why it’s best to try to limit the number of opioids prescribed.

If your pain continues or increases after you get home from the hospital, when should you call your provider?

It’s normal to have perineal pain or C-section incision pain. But call your provider if you have chest pain or a hard time breathing, or pain or a lump in your legs or if you notice any redness, swelling, or heat on your body.

For more information about women’s health services and postpartum care at Intermountain Healthcare visit:

https://intermountainhealthcare.org/services/womens-health/

https://intermountainhealthcare.org/services/women-newborn/conditions/postpartum-care/

https://www.youtube.com/watch?v=dX22DuYu1Yk&list=PLIWYdYatjvoNTVyRVDOPeDfuER5vLTgum&index=3

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


Expecting twins or multiples



It seems like more people are expecting twins these days, and there are stories on the news about triplets, quads and more. What’s going on here? And what should moms know if they’re expecting multiples?

If you’re expecting more than one baby or think you might end up with multiples due to beginning fertility medication or treatment, you’ll want to listen in.

Jade Elliott is joined by Dr. Helen Feltovich, a maternal fetal medicine physician with Intermountain Healthcare who specializes in high-risk pregnancies  to answer common questions about expecting multiples.

Is the Number of Twins and Multiples Increasing?

Actually, the number of multiples being born has decreased slightly in recent years, probably due to responsible assisted reproductive technologies.

What Increases Your Chances of Having Twins or Multiples?

While fertility medication or in vitro fertilization may increase your chance for carrying multiples, there are other factors, like genetics or demographics that can come into play.

  • Family history of twins or multiples
  •  Over age 35
  • Previous pregnancy
  •  Taller than average
  • Obesity – Body mass index of 30 or higher
  • African American women are slightly more likely to have twins

If you have multiple factors, your odds of having multiples, multiplies!

Types of Twins

Identical twins is the common name for “monochorionic” twins, which means one placenta. These twins result from the fertilization of a single egg that splits in two. Identical twins share all of their genes and are of the same sex.

Fraternal twins is the common name for “dichorionic” twins, which means two placentas. These twins result from the fertilization of two separate eggs during the same pregnancy. They share genes just like any other siblings. Fraternal twins can be of the same or different sexes.

The only way to really know if your twins are identical is through genetic testing. In some very rare cases, there can be identical twins that are different in some important ways, like sex.

With Good Prenatal Care, Most Twin Pregnancies Result in Healthy Babies

Most twins are delivered past 36 weeks. The estimated due date is at 40 weeks of pregnancy, and 37 weeks is considered term. Half of twins are delivered after 36 weeks, and half before then, either because of spontaneous labor or because of a maternal or fetal problem that requires delivery. Multiples higher than twins often arrive earlier.

Risks of Carrying Multiples

  • Preterm labor
  • Pre-eclampsia (high blood pressure)
  • Gestational diabetes
  • Miscarriage
  • Placenta complications
  • Fetal growth concerns, especially for monochorionic (identical) twins
  • Increased risk for postpartum depression or anxiety due to complications

Prenatal Visits Are Even More Important If You’re Expecting Multiples

When you’re expecting twins or multiples, your doctor will likely want you to have more prenatal visits than for a singleton pregnancy due to a higher chance for complications. You’ll also likely need additional ultrasounds and fetal monitoring during pregnancy to check for any complications. That’s why it’s important to not skip prenatal appointments.

When to See a Maternal Fetal Medicine Specialist

If your doctor is not comfortable with managing or delivering twins, or if you have additional complications, you’ll probably be invited to see a maternal fetal medicine (MFM) specialist. This is especially true if your babies are monochorionic (identical). MFM specialists are trained in obstetrics and gynecology like general obstetricians, but then they do an additional three years of training specific to high risk pregnancies and deliveries. If you’re expecting three or more babies, it’s highly recommended you see an MFM specialist.

If there is not an MFM specialist in your area, ask your doctor about consulting with one through telehealth. We try to keep patients close to their home.

Things to Do at Home If You’re Expecting Multiples

  • Take prenatal vitamins as you would for a single pregnancy.
  • Drink plenty of water to stay hydrated
  • Eat well. Don’t focus on the number of pounds to gain. Your provider will watch the weight of your babies with growth ultrasounds.
  •  Get enough exercise

Bed rest is not recommended just because you’re expecting multiples.

Be Aware of the Signs of Preterm Labor

If you feel more pressure or have cramping, bleeding, or are leaking fluid, or have decreased fetal movement, call your doctor.

Prepare for the Postpartum Period

Set up social support for after the babies arrive. Your chances of having premature babies or a Caesarean delivery are higher when you are carrying multiples. If your babies are born prematurely, one or more of your babies may need to stay in a neonatal intensive care unit. You may want to think about how close you live to a hospital with a NICU or ask your provider if they have access to telehealth consultations for your baby.

You may be at higher risk for postpartum depression or anxiety due to increased stress or complications.

Breastfeeding

Breastfeeding is best for babies, especially premature babies. It is possible to nurse multiples successfully. If breastfeeding is not working, there’s no shame in needing to supplement with formula.

For more information, here are some helpful links:

https://intermountainhealthcare.org/

https://intermountainhealthcare.org/services/womens-health/intermountain-moms/

https://intermountainhealthcare.org/locations/intermountain-medical-center/medical-services/women-and-newborn-care/women-and-newborn-services/high-risk-pregnancy/

https://intermountainhealthcare.org/primary-childrens/programs-specialties/fetal-program

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


Helping siblings adjust to a new baby



Having a first baby is exciting. Having a second baby and introducing them to the sibling brings its own set of stresses for some. How will the sibling respond? How best to introduce the baby to the family?

Jade Elliott spoke with Peter Lindgren, pediatrician, Intermountain Healthcare, to learn about the best ways to introduce a new baby to the family on this episode of hte Baby Your Baby Podcast.

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“It’s an adventure, and perfectly normal for parents to feel anxious about having another baby,” said Lindgren.. “My sister’s first response when I came home from the hospital was, ‘Send him back.’ But there also are many more stories of children who adore their new baby sibling, and often reflect the care and love that they have received.”

A new baby changes the family’s structure. Siblings might respond with feelings of betrayal or that they’ve been replaced or a regression in behavior. Mothers often experience a change in their relationship with an older child. Many fathers take on a more important role with older children, particularly as mothers feed a newborn.

There is no one recipe for how to introduce baby to his or her siblings. But here are some tips on how you can help children – and yourselves – through change:

Involve Siblings

– Before the baby is born, talk to your children about having a new sibling. For children under 2 years, it’s helpful to wait until the baby is closer to delivery (around 30 weeks of pregnancy).

– Read books together, such as “Peter’s Chair” by Ezra Jack Keats and “I’m a Big Brother/Sister” xx by Joanna Cole.

– Make caring for baby a team sport by including older siblings.

Reassure and teach

– Play it cool, but don’t be afraid to show your feelings. Children learn to navigate the world by watching their parents.

– Acting out is normal. Recognize the behaviors that you want to see.

– Jealousy can’t be avoided. Reassure, spend time with, hug, and make physical contact with older siblings.

– Keep your sense of humor!

More to think about

– Showering siblings with gifts is likely to make them feel like something really ominous is going on.

– Some wonder if the newborn should give a gift to the older sibling. Consider your older child’s personality before deciding.

Be Kind to Yourself

It’s okay to let your child respond in whatever way they are going to respond. Give them time to process their feelings, and yourself time to find your family’s new equilibrium. Remember that you get to do all of this in a sleep-deprived state, while recovering from a physically and emotionally intense experience. Above all, be kind to each other and yourselves.

For more information, please visit IntermoutainHealthcare.org.

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


Making it through morning sickness



So, you’re excited to be pregnant. You’re supposed to be glowing, but instead you look kind of green. If you feel nauseous or you just threw up, it’s probably morning sickness.

Jade Elliott spoke with  Hannele Laine, here an OB/Gyn from Intermountain Healthcare To help you know how to make it through morning sickness.

Morning sickness is common and may be under-treated

According to the American College of Obstetricians and Gynecologists, 50-80 percent of pregnant women experience nausea and 50 percent experience vomiting or retching.

Morning sickness may be undertreated. It often begins prior to the first appointment, so women sometimes wait for the appointment rather than asking for help. In addition, women may not seek treatment because they believe it is common and usually temporary or because they’re concerned about the safety of taking medications while pregnant.

What causes morning sickness?

The specific cause of vomiting during pregnancy is not known. One hypothesis is that it due to the change in hormones levels during pregnancy.

Common myths about morning sickness:

1. It only occurs in the morning. False: You can have morning sickness any time of day.

2. It’s resolves after the first trimester. False: A few women have it last into the second and sometimes even into the third trimester.

3. It harms the baby. False: Typical morning sickness does not harm the fetus.

What increases your risk of severe morning sickness?

Severe nausea and vomiting of pregnancy is called hyperemesis gravidarum. It is more likely to occur with these risk factors:

• A twin or triplet pregnancy.

• A previous pregnancy with nausea and vomiting.

• In women who have family members with nausea and vomiting of pregnancy.

• A history of motion sickness or migraines.

• Being pregnant with a female fetus.

Simple ways to help reduce morning sickness:

  • Eat small meals, every 1-2 hours to avoid a full stomach and to avoid hunger.
  • Eat bland, dry foods like crackers, cereal, toast or baked potatoes.
  • Eat some protein with every meal.
  • Avoid spicy or fatty foods.
  • Eat something before you get out of bed. Keep crackers on your nightstand.
  •  Take prenatal vitamins at night after a meal or switch to folic acid alone.
  • Avoid unpleasant smells as they may trigger nausea.
  • Try ginger capsules or candies, ginger ale or tea made with real ginger.
  • Wristbands that put pressure on or electrically stimulate a pressure point on the wrist may help.

How to prevent morning sickness from becoming severe:

  • Avoid getting dehydrated. Try taking little sips all day of something like Gatorade.
  •  Seek treatment early to prevent severe symptoms requiring hospitalization.
  •  Talk to your provider about how to manage your morning sickness and review possible medications that can help.
  •  Keep your prenatal visits and call if you are having trouble between visits.

When to call or see your provider:

• If nausea or vomiting is severe

• You pass only a small amount of urine or it’s dark in color

• You can’t keep liquids down

• You feel dizzy or faint when you stand up

• Your heart races or is pounding

• You’re losing weight

• If nausea or vomiting begins after nine weeks of pregnancy

Severe nausea and vomiting could be caused by something else:

Warning signs that your nausea and vomiting may be due to another cause:

• abdominal pain or tenderness

• fever

• headache

• thyroid enlargement or swelling on the front of the neck

• nausea and vomiting that occurs for the first time after nine weeks of pregnancy.

If you have severe nausea and vomiting, your provider may want to do additional tests to evaluate other causes of the symptoms. Some medical conditions can cause nausea and vomiting during pregnancy such as an ulcer, food-related illness, thyroid or gallbladder disease.

For more information visit: https://intermountainhealthcare.org/services/women-newborn/

For additional information, click here.

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


Newborn care: the first few days at home



Bringing home a new baby is an exciting time for everyone in the family, and often a time with many questions.

Jade Elliott talked down with Dr. Kaitlin Carpenter a pediatrician from Intermountain Healthcare, to help guide new parents through those first few days when you may feel excited, yet overwhelmed about caring for this tiny, new, helpless human.

You probably have a lot of expectations about motherhood, but the most important thing is to be flexible. Babies are unpredictable, and in the beginning it may feel like everything revolves around what the baby needs. Give yourself time to adapt to your new life and eventually, you’ll settle into a new routine.

Sleep Strategies

Grandma’s suggestion of “sleep when the baby sleeps” really is true. As much as you can, take advantage of these breaks by taking a nap yourself. Babies often have “day/night reversal” and will spend the first few weeks up all night and sleeping more during the day.

Babies are safest when they sleep on their backs in their own bassinet or crib. Avoid co-sleeping or falling asleep with a baby under six months old in your bed. Do not smoke, drink alcohol, use illegal drugs or misuse prescription drugs. Studies show these practices help lower the incidence of sudden infant death syndrome or sudden unexpected post-natal collapse.

Weigh the Pros and Cons of Visitors

There can be a lot of pressure to have visitors, but it’s okay to set boundaries or say “no” or ask visitors if they’ve been ill, or ask them to wear a mask, especially during the COVID-19 pandemic, or flu and respiratory virus season.

On the other hand, having a newborn is a time to ask for help. Think who in your life you can rely on to safely give you a break when you need it. Having someone come hold the baby while you nap can be a lifesaver!

How Often to Feed Your Baby

One of the most common questions I get asked is if a newborn is eating too often. It is normal for newborns to “cluster feed,” especially at night for the first few days and then again during growth spurts. During these times, the baby may want to eat every 30-45 minutes for several hours in a row and that is normal! Go with it. The baby is the boss. Breastfeeding works by supply and demand. The more frequently you feed the baby, the more breastmilk you will produce.

Grandmothers know a lot and are a great resource for all sorts of things. Some ask if the newborn can have water, which we do not recommend anymore.

Newborns can be very loud. Grunting, tooting, sneezing, and hiccupping are all normal baby sounds.

Diaper Duty

Be sure to keep baby clean and dry by changing wet and soiled diapers. This will help prevent diaper rash. Baby’s first few bowel movements are called meconium and are dark black and sticky. Then as they begin breastfeeding or drinking formula, bowel movements become more yellow and runny. When cleaning baby’s bottom, wipe down away from reproductive organs to keep germs from getting into those openings. If your baby is not producing frequent wet or dirty diapers, call your provider.

Keeping Baby Safe

Remember that newborns cannot hold up their own head, so you’ll need to support their neck carefully when you’re holding your baby or handing your baby to someone else or placing your baby in an infant car seat, swing or stroller.

It is safe to take your baby on walks when you feel up to it. Getting outside for some fresh air and walking have positive physical and mental health benefits for the whole family. Make sure to secure your baby safely in a front pack or stroller. Try and keep your little one protected from the sun by keeping them in the shade. They are too young for sunscreen, so floppy hats and lightweight clothing can help.

Bath Time Bonding

Bath time is a great way for your partner to participate in baby’s care. You can use a baby bathtub to help make bathing easier and safer. Baby bath products and shampoo are designed for baby’s sensitive skin and to not irritate baby’s eyes. Be gentle and careful when bathing your baby. Babies are slippery when wet! Never leave your baby unattended in bathwater.

Some grandparents ask if alcohol swabs should be used to clean the belly button. We do not recommend that anymore. Just clean the area with soap and water. The remains of the umbilical cord will fall off naturally.

Newborn Skin Care

Most newborn skin peels a lot for the first few weeks. This is normal and nothing to worry about. You can apply baby lotion after their bath or put a little baby oil in their bathwater to help moisturize their skin.

Newborns get a lot of different kinds of rashes. Baby acne is common. Most rashes are not a big deal, but a few types may need treatment, such as herpes. If you are concerned about a rash, call your provider, ask about it at the baby’s well check-up or schedule a TeleHealth visit through Intermountain Connect Care.

Mom Self-Care

The newborn period is not as glamorous as many movies make it out to be. Embrace it! Your body has just gone through a huge transformation and will continue to change over the next months to years.

Remember to eat. Sometimes it’s hard to get in three meals every day. For breastfeeding moms, you are burning the same amount of calories breastfeeding as running a 5K every day, so don’t skimp on the calories!

Baby Blues and Postpartum Depression

Watch out for the baby blues. It’s normal for emotions to quickly go from up to down after having a baby, especially because of all of the hormonal changes and sleep deprivation. This should get better in a few weeks.

Post-partum depression or anxiety is something more serious and if these feelings persist, it’s important to talk to your doctor about them. If you find yourself spending more time being sad or anxious than being happy, or having a hard time feeling able to take care of yourself, or if you feel your emotions are keeping you from bonding with your baby, please reach out to your pediatrician or OB. We want to help, but it’s hard to know who is struggling unless you speak up.

Well Baby Check-Ups

Be sure to go to your baby’s well check-ups at your pediatrician’s office. These are normally recommended beginning at two weeks of age and then also at two months, four months, six months, 12 months, 15 months, 18 months and 24 months. Annual check-ups are recommended after age three. These check-ups help you know if your baby is gaining weight and growing and developing normally. This is also when your baby will receive important vaccines to prevent common childhood illnesses and important screenings are done for hearing and vision, etc.

Sibling Strategies

  • Older siblings can take some time to adjust to their new role. Make it a positive thing, saying “You get to be a big sister!” instead of “You aren’t the baby anymore.”
  • Expect some jealousy and maybe a developmental regression, especially if you have been working on potty training
  • As much as you can, let the older sibling help bring diapers or snacks to mom or have them “feed” their own baby doll during breastfeeding or bottle feeding.
  • A little one on one time with mom or dad goes a long way. Try to carve out time during the day to snuggle and give some undivided attention to your older child.

For more information visit: https://intermountainhealthcare.org/services/pediatrics/

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


Sleep strategies for pregnant moms



If pregnancy can make you more tired, why is it sometimes so hard to get a good night’s sleep?

Jade Elliott spoke with Hannele Laine, an OB/Gyn from Intermountain Healthcare,  about the reasons many women experience sleep challenges during pregnancy and some strategies to help you get a better night’s sleep.

Sleep disturbances are common in pregnancy, especially in the third trimester as your baby grows larger and it’s harder to get comfortable. Common problems include difficulty falling asleep, increased waking at night, experiencing lighter sleep and shortened sleep intervals of deep sleep, which can all leave you feeling less rested.

This is likely due to a combination of factors including hormonal, physical and emotional changes as well as medical issues related to pregnancy.

According to the National Sleep Foundation’s 1998 Women and Sleep poll, 78 percent of women report more disturbed sleep during pregnancy, than at other times. Another study found that 97 percent of women had an average of three wakings per night in the third trimester. Lastly, there is some evidence that inadequate sleep – less than five to six hours, may negatively impact pregnancy and labor as well.

Physical causes of sleep problems during pregnancy:

  • Nausea
  • Heartburn/reflux
  • Difficulty in finding a comfortable position
  • Increased nighttime urination
  • Restless legs
  • Leg cramps
  • Low back pain
  • Sleep apnea

Emotional reasons sleep may be more difficult during pregnancy:

Many women worry about the birth, balancing motherhood and work, adding another child to the family, relationship changes and more. In addition, anxiety and depression are more common in pregnancy and the postpartum period and are frequently associated with sleep disturbances. And the current COVID-19 pandemic has added additional worries for pregnancy, delivery and motherhood.

But, there is hope! There are many things you can do to improve your sleep, including behavioral strategies, counseling and sometimes medication. Be sure to discuss sleep concerns with your doctor, especially if it’s impacting your normal functioning at work or with your partner or family. If you are having depression or anxiety, there is good evidence that treating it during pregnancy improves outcomes for women and their babies.

Tips for better sleep hygiene:

  • Keep a regular sleep schedule.
  • Create a relaxing bedtime routine – dim the lights, take a warm bath/shower, practice mind-quieting techniques.
  • Reduce stimuli – no screen time on TV, phone, or computer for two hours before bed.
  • Practice mindfulness or meditation.
  • Exercise for a minimum of 20 minutes per day, but not close to bedtime.
  • Avoid naps late in the day.
  • Avoid caffeine in the afternoon or evening.
  • Create a comfortable sleep position with extra pillows for cushioning (between legs, under your tummy or back).
  • Plan for 7-9 hours of sleep.

Tips for pregnant women to improve their sleep:

  • For increased nighttime urination – decrease fluid intake in the evenings.
  • For heartburn/GERD – avoid food that are spicy, acidic or fried. Take an over the counter antacid such as Tums.
  • For leg cramps – avoid soda/carbonated drinks. Add a calcium supplement likeTums.
  •  For restless legs – if your iron level is low, ask your doctor about an iron supplement.
  • For sleep apnea — if you snore three or more times per week or your partner reports you stop breathing during sleep, talk to your doctor about testing.
  •  Discuss any herbal supplements or over the counter medications with your doctor.
  • If sleep issues don’t resolve, talk to your doctor about when sleep medications such as Unisom, Benadryl, or melatonin can be used during pregnancy.

Sleep post-partum is also an issue:

  • Babies wake every three hours on average. So even though the sleep you get tends to be better quality, it is very disrupted and therefore easy to have inadequate sleep.
  • Continue to practice good sleep hygiene postpartum.
  •  Go to bed at the same time as your baby if possible.
  •  Consider a morning walk to help with day/night rhythm.
  • Sleep when the baby sleeps during the day.
  • Ask your partner, friend or family to help you prioritize sleep. (They could watch the baby, or do laundry, grocery shopping, meal preparation, etc.)
  • Contact your doctor if you note increased anxiety or depression.

For more information visit: https://intermountainhealthcare.org/services/women-newborn/

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.