Labial Adhesion

Today, I took my daughter in for her 9 month check up. Everything was great. She's healthy and on track with her development and growth. However, she has what is known as a labial adhesion. Since I had zero clue as to what this was, I have decided to research it and do a blog entry on it to not only inform myself but other Mommies and Mommy to be's as well.

• What is a labial adhesion?

Labial adhesions are a sticking together of the outer lips (labia) of the vulva. The vulva is the area outside of the vagina.This type of adhesion occurs most commonly in girls who are between 3 months to 6 years of age, and can persist until puberty.

• Signs and symptoms of labial adhesions

Some children with labial adhesions will have no symptoms, while others may have pain in the genital area, difficulty urinating, or frequent urinary tract (bladder) infections. The diagnosis is made by looking at the vulvar area and observing that the vaginal opening is either partially or fully covered by the labia with a white line indicating the adhesion. If your daughter is having symptoms such as pain, particularly when she is in a straddle position (for example, while sitting on a riding toy), or having trouble passing urine, you may have discovered that her labia appears to be stuck together. If your daughter has not had any symptoms, her health care provider may have noted the adhesions during a routine well-child check.

• What causes labial adhesions?

It is not clear why some young girls develop labial adhesions. It is thought that low levels of estrogen (that girls normally have during childhood) and vulvar irritation can result in the labia sticking together. Labial adhesion can develop as early as 6 to 8 weeks after birth.

Baby girls who have just been born don’t have labial adhesions because of high levels of estrogen passed on from the mother during pregnancy. Similarly, high levels of estrogen from puberty make it very unlikely for girls who are menstruating to develop adhesions.

• Treatment for labial adhesions

Whether or not treatment is recommended depends on how severe the adhesions are.

Small or mild adhesions do not cover the vaginal opening and may separate by themselves when your daughter reaches puberty or earlier. Your daughter’s health care provider will continue to watch how your daughter’s labia appear over time, and may recommend treatment if the adhesions get worse or cause symptoms.

Slightly larger or moderate adhesions that cover the lower part of the vagina may be treated with a mild emollient, such as A & D ointment®, along with gentle separation twice a day over several weeks.

Significant adhesions that cover the vaginal opening, and often the urinary opening as well, can be effectively treated with anestrogen-containing cream. These adhesions may prevent drainage of normal vaginal secretions, as well as impair the flow of urine. Sometimes this will cause urine to collect in the lower vagina, behind the adhesion, and can lead to irritation or dribbling of urine after your daughter stops urinating. If she develops a fever, it will not be possible to collect a clean urine specimen to see if she has a urinary tract infection. The most effective treatment for significant adhesions is an estrogen-containing cream applied twice daily for a period of time or until the adhesions resolve. This treatment requires a prescription from her health care provider.

Here is a photo depicting what each looks like:

My daughter is having to do the estrogen cream although her urethra is not covered to my knowledge. We will have to do it twice a day for two weeks or until the adhesion resolves. Then we will have to continuously apply Vaseline to that area.

• How will I know if the estrogen cream is working and is it safe to use?

Over time small openings will appear in the white line as the adhesion gradually disappears. Yes. Estrogen-containing creams are safe to use for the treatment of labial adhesions. Only a very small amount of estrogen cream will be used, for a limited amount of time. A few girls who are treated with estrogen cream may develop temporary small breast buds or darkening of the labia. Both of these conditions are not dangerous, and will go away once treatment is stopped. You should make an appointment with your daughter’s health care provider as soon as the (labial) separation is complete so you can stop the estrogen treatment and change to Vaseline® or A & D ointment®. If you are pregnant or worries about absorbing any estrogen, you can use medical type gloves (which you can buy in most pharmacies) while applying the estrogen cream.

• What if treatment doesn't work?

Reasons that the treatment fails may include applying the cream all over the vulva, instead of focusing just on the adhesion area or not applying enough cream. It is possible but rare that very thick adhesions won’t respond to treatment, even if the right amount of cream is used in the right area. If your daughter’s adhesions do not improve with the estrogen cream, you should discuss other treatment options with her health care provider. Some girls have success with a short course of steroid ointment.

• Is treatment necessary once the adhesions open up?

Labial adhesions can recur or come back, even after they open up. Once the labia are separated, Vaseline or A & D ointment is used as an emollient for 6-12 months to keep the labia open and prevent or lessen irritation of the vulva area.

Ways to help keep your daughter’s labia open:

1. Have her take a daily tub bath
2. After her bath, pat dry her vulva area with a soft towel
3. Apply a thin amount of A & D ointment to her dry labia

Harsh soaps, scrubbing the vulva, and tight clothing should be avoided.

Try to be patient with the course of treatment which can last up to several weeks, and possibly require additional follow-up visits to your daughter’s health care provider (HCP). If the labial adhesions come back, do not restart the estrogen cream again unless you have discussed this with her HCP.

Sources: Young Women's Health

Some of the Main Birth Control Options

Birth Control Options
Choosing between pills? Hormonal or Non Hormonal?
Here is a big list Of Birth Control Options..
Abstinence--- haha Funny but still had to say :)

Pull Out Method-- If used correctly can be great Birth Control
but you HAVE to know your cycle perfectly!!

Condoms-- They do have a male(most commonly used) and Female(Femy,Protectiv, Reality)

Birth Control Pills-- (Estrostep Fe, LoEstrin 1/20, Orth-Novum 7/7/7,
Ortho Tri-Cyclen Lo, Yasmin, Yaz) This birth control mainstay is still
  99% effective against pregnancy when taken around the same time every
  day. It's also known for easing hot flashes and restoring regular periods.

Progestin-only Pill-- (Micronor, Nora-BE, Nor-QD, Ovrette)Known as the
  mini pill, progestin-only meds don't contain estrogen. They're safer
  for smokers, diabetics, and heart disease patients, as well as those at
  risk for blood clots. They also won't reduce the milk supply for women
  who are breast-feeding.
Extended-cycle Pill-- (Lybrel, Seasonale, Seasonique) These pills
  prevent pregnancy and allow you to have a period only every three
  months. (Note: Lybrel stops your period for a year, but you must
  take a pill every day, year-round.)
Vaginal Ring-- (Nuva Ring) What is does: The ring is made of flexible
  plastic and delivers estrogen and progestin, just like the combination
  pill. You place the ring in your vagina for three weeks, and then remove
  it for one week so that you have a regular period.
Diaphragm-- (Milex Wide Seal, Ortho All-Flex, Semina, SILCS)
  What it does: Made of rubber and shaped like a dome, a diaphragm prevents
  sperm from fertilizing an egg. It covers the cervix and must always be used
  with a spermicide. Women must be fitted for a diaphragm in their doctor's office.
IUD--(Mirena, ParaGard) What it does: ParaGard is a surgically implanted copper
  device that prevents sperm from reaching the egg. Mirena, also surgically implanted,
  works by releasing hormones. Intrauterine devices (IUDs) are more than 99% effective
  and good for 10 years.
Patch-- (Ortho Evra) What it does: You can place the hormone-releasing patch on your
  arm, buttock, or abdomen, and rest easy for one week.

Implant--(Implanon, Norplant)  What it does: About the size of a matchstick, the implant
  is placed under the skin on your upper arm. Implants last for three years and can cost
  up to $800. They are nearly 100% effective
Sterilization-- (Essure, Tubal Ligation, Vasectomy)  What it does: Women can undergo either
  tubal ligation, a surgical procedure that blocks the fallopian tubes from carrying eggs
  to the uterus, or tubal implants (Essure), a nonsurgical technique in which a small coil
  is inserted into the fallopian tubes. The sterilization process is less risky for men: A
  vasectomy is a minor surgery in which the tubes that carry sperm from the testicles are cut.

Common Side Effects
Birth Control
BIRTH CONTROL AND RISKS!!!

TOP 10 REASONS WHY YOU’RE NOT LOSING WEIGHT EATING LCHF

Too Many Carbohydrates – are carbs starting to sneak back into your diet? Be honest and start tracking everything using My Fitness Pal. A little treat here and there adds up. Some are more carb sensitive (or insulin resistant) than others. I know that my carbs have to be around 50g/day to be feeling great and in control of my appetite. Lower than that and I will lose a little bit of weight, above that and I know my weight loss will stall. I generally go between 35-70g/day without too much tracking because I have done it for so long.

1. Too Much Fruit – yes I use berries on my breakfast and desserts, but that is it. I allow my children to eat fruit (without gorging) as their nutrition value, far outweighs their carb content. But this is only because my children are healthy, active and don’t need to lose weight. For me, the sugar and fructose in fruit is too much. Sure, enjoy it as a treat and eat only low carb nutritent dense berries. See fruit as an occasional sweet treat. Packed with fibre, antioxidants, nutrients………
2. Too much Dairy – my biggest downfall is milk. I can drink it by the glass full. Now milk is great, full of protein and calcium, but it also contains about 5% carbs. A average glass of milk can be 250ml which is 12.5g carbs – quite a lot, especially if you have a glass or 2 a day. Most dairy does contain around 5% but you are more likely to drink a large glass of milk than eat 250g of full fat cheese. Go back and track just how much cheese, cream, milk, yogurt and other dairy products you are having. Dairy products also contain a lot of protein, which can (via gluconeogenesis) turn into glucose in the body.
3. Nuts – this was my other mistake. Snacking on too many nuts, too often. Nuts are a great source of fibre, omega 3, selenium. Also watch which nuts you consume. Cashews are the worst for carbohydrates, about 20%. Also make sure your nut mix doesn’t contain any dried fruit. The trail mixes are the worst. Measure out a small dish of nuts and make them last for the day. Buy nuts in their shells so it takes longer to eat them.
4. Not Enough Fat – yes, to lose weight you need to eat more fat. I got to the point where nothing was working for me to loose weight, so I thought “I’ve tried everything else, why not?”. It was the best thing I ever did. Honestly, by eating more fat, I have lost my appetite. I have to admit that I snack on butter slices when cooking dinner, or have a spoon of coconut cream to take the edge off my hunger, best of all – a creamy coffee. Don’t fear the fat.
5. Too Many Artificial Sweeteners – I believe diet drinks have a place in weight loss, but certainly not long term. I see them at the start to get over my sugar cravings and to fill up when I was hungry but they should be of short term use. I also use them in my baking and desserts, but I don’t make desserts and sweet treats a huge part of my life anymore. The whole point is to get off the sugar and the sweet treats. Artificial sweeteners can affect appetite and make you think that if a recipe contains them, then it’s OK to eat more. If your weight loss has stopped, stop the diet drinks and see how you go.
6. Eating Too Often or Eating Too Little – some say you should snack little and often throughout the day. You need to learn what real hunger feels like and actually get used to the fact that being hungry is actually OK. The other extreme is to eat too little, you become so starving that you end up eating something you know you shouldn’t and sting far too much of it. Eat when you really think you need a meal, and make it nutritious. If all you want is a sweet treat, but not real food, then its probably a craving and not hunger. Cravings are a sign of insulin resistance, learn to resist them, reset your metabolism, you will finally gain control of your appetite.
7. Be Patient– this has to be the hardest lesson to learn. I was really strict with LCHF, and for the first couple of months, I lost hardly anything. This is hard when every time I went on weight watchers, the kilos drop off. But that weight loss was never sustainable. I am still loosing weight now, probably half a kilo every month. This will probably stop soon as your body finds its own natural weight, and my carb intake needs to be realistic that I can continue. Keep reminding yourself that your way of eating now is so more nutritious than when you ate carbs and processed foods. The weight WILL go, you WILL gain control of your appetite, and you WILL succeed.
8. Lack of Sleep – lack of sleep and increased stress are critical to weight loss and wellbeing.
9. Caffeine – caffeine is a stimulant which increases you adrenaline (short term hormone that gets you out of danger – “fight or flight”). It stimulates the liver to release glucose from its glycogen stores. What happens next? This new high level of glucose causes insulin to be released again, fat gets stored and fat burning turns off. If weight loss has stopped, can’t sleep, too stressed, stop the caffeine. You don’t have to give up your coffee, but just has a decaffeinated coffee and see how you feel.

Foundation to a Good Relationship

“A house must be built on solid foundations if it is to last. The same principle applies to man” - Sai Baba

Having a happy and successful relationship is not necessarily easy. It takes work. The two people in the relationship need to be committed to giving 100% of themselves. So, what does it take to have a solid foundation for a healthy relationship?

• Laugh Together

“It is impossible for you to be angry and laugh at the same time. Anger and laughter are mutually exclusive and you have the power to choose either”. - Wayne Dyer

Laughter is a choice. By choosing to laugh with your partner,  it shows that you enjoy each others company, feel positive towards one another and actually “like” each other. Choose to make your partner laugh at least once a day.

• Know each other's love language

“We must be willing to learn our spouses love language if we are to be effective communicators of love” - Dr Gary Chapman

Love languages are the different ways we communicate and understand love. We all have different love languages. Love languages can be as different as English and Chinese, so it is important to understand each other's love language. The 5 typical love languages are: 

1. Words of Affirmation

Phrases such as "I love being in love with you.", "Thank you for always being there for me.", "You look beautiful/handsome today.", and "I don't know what I would do without you." 

2. Quality Time

Simply watching a movie, talking, taking a walk together, or any other small activity where it is just the two of you being with each other.

3. Receiving Gifts

It doesn't have to be expensive. A card, some flowers, anything that simply says, "You were on my mind and I appreciate you."

4. Acts of Service

Taking out the trash, doing the laundry, washing the dishes, etc. Something that may seem small and insignificant but will make them appreciate your help and efforts.

5. Physical Touch

This does not just mean sex. It means holding hands, kissing, hugging, back rubs, etc. Any small physical interaction can mean so much to your partner.

Here is an example of understanding your partners love language: 

• If your love language is physical touch, a kiss will speak louder than 1000 words – but,

• If your love language is words of affirmation, one kind or affirming word will speak louder than 1000 kisses.

Although you may be showing your partner love in every way you know how, it may not be enough. You need to understand their love language.

• Understand Love as an Action

“Love is a verb. Love – the feeling – is a fruit of love, the verb” – Stephen Covey

Love is an action. 

Love is understanding how your partner feels loved, and then doing it.

People often think that love is a feeling, and that once the feeling disappears – there is little hope for their relationship. That is absolutely not the case. 

When you choose to love your partner (even if they didn’t do anything to deserve it), you are showing them real love. Love, that is unconditional and that does not rely on them loving you first.

If you view love solely as a feeling, you will wait for a long time and still not "feel" it. Love is a feeling, but it is also a choice. A choice that has to be backed up with action.

• Don't cross the line.

There are certain things you should never say or do to your partner. Crossing the line may include:

1. Losing your temper.

Obviously, we all get angry. The important thing is how you handle the anger. Talk a walk, go into another room, give each other some space for a little bit so you can cool down.

2. Yelling or screaming at your partner.

This can make them angry or even sad. It can make them feel like a child being scolded. You should never attempt to talk to your partner while angry. Cool down, then discuss the issue calmly.

3. Saying "I hate you."

There are some things you can not take back regardless if you meant it or not in the heat of the moment. This is one of those things. While your partner may "forgive" you, it will always be in a corner of their mind.

4. Calling your partner unkind names.

This is pretty self explanatory. It belittles them and makes them feel less than they should. You should NEVER call your partner anything outside of their name.

5. Using manipulation to get what you want.

When you manipulate, you use a form of lying. This breaks trust overtime.

6. Getting aggressive toward your partner.

It is never okay for either of you, man or woman, to lay your hands on your partner. This is abusive and what may have been a healthy relationship crosses the line into an unhealthy relationship. NEVER argue while angry. Calm down and try to discuss the issue once both parties are calm and collected.

Once you begin crossing the line, it becomes easier and easier to do it over and over again.

• Apologize often.

“In general, pride is at the bottom of all great mistakes” - John Ruskin

Love is not prideful.

We all make mistakes. We are human. Do not make the mistake of being proud. Apologize so you can move past what it is that needs apology to begin with.

• Trust

"Love is weakest when there is more doubt than trust, but love is strongest when we learn to trust in spite of the doubts."--Unknown

Be completely honest with each other to begin with. Discuss past issues with each other by listening and keeping an open mind. Be truthful in even the smallest situation. Give your partner trust and try not to question or doubt whether they are being truthful with you. 

• Communication

"Communication is the life line of any relationship. Without it, the relationship will starve itself to death." --Elizabeth Bourgeret

Communication is a necessity in a relationship. You should always be respectful in how you communicate with your partner.

What is a Blighted Ovum??

Do you think you could have a Blighted Ovum? Here is some Symptoms!


A blighted ovum can occur very early in pregnancy, before most women
even know that they are pregnant. You may experience signs of pregnancy
such as a missed or late menstrual period and even a positive pregnancy
test. Many women assume their pregnancies are on track because their hCG
levels are increasing. The placenta can continue to grow and support itself
without a baby for a short time, and pregnancy hormones can continue to rise,
which would lead a woman to believe she is still pregnant. A diagnosis is usually
not made until an ultrasound test shows either an empty womb or an empty
gestational sac.  It is possible that you may have minor abdominal cramps, minor
vaginal spotting or bleeding.

What can cause a Blighted Ovum??


A blighted ovum is the cause of about 50% of first trimester miscarriages and is
usually the result of chromosomal problems. A woman’s body recognizes abnormal
chromosomes in a fetus and naturally does not try to continue the pregnancy because
the fetus will not develop into a healthy baby. This can be caused by abnormal cell
division, or poor quality sperm or egg.


What should you do in case of a Blighted Ovum??


It is really up to you! You can either have a D & C or you could Pass it on your own!
It is believed that a woman’s body is capable of passing tissue on its own and there
is no need for an invasive surgical procedure with a risk of complications. A D&C would
however be beneficial if you were planning on having a pathologist examine the tissues
to determine a reason for the miscarriage. Some women feel a D&C procedure helps with
closure, mentally and physically. Others feel like a D&C is an invasive procedure that
can make the loss more traumatic.


Can a Blighted Ovum be Prevented??

Unfortunately, in most cases a blighted ovum cannot be prevented.  Some couples will seek
out genetic testing if multiple early pregnancy loss occurs. A blighted ovum is often a one
time occurrence, and rarely will a woman experience more than one. Most doctors recommend
couples wait at least 1-3 regular menstrual cycles before trying to conceive again after
any type of miscarriage.

American Pregnancy-Blighted Ovum

Signs of labour

How will I know when I'm in labour?

Every woman's experience of labour is different. You may only be able to work out when labour truly started after you've been through it! However, changes that take place in pre-labour and early labour may cause tell-tale signs and symptoms that labour is imminent.

In pre-labour or early labour (the latent phase), you may have: 

• Persistent lower back pain or abdominal pain, with a pre-menstrual feeling and cramps.
• Painful contractions or tightenings that may be irregular in strength and frequency and may stop and start.
• Broken waters. Your membranes may rupture with a gush or a trickle of amniotic fluid. Although this can happen long before labour starts, you should still, call your maternity unit to let them know.
• A brownish or blood-tinged mucus discharge (bloody show). If you pass the mucus plug that blocks the cervix, labour could start soon, or in a few days. It's a sign that things are moving along.
• An upset tummy or loose bowels.
• A period of feeling emotional, excited or moody. You might feel restless, anxious or impatient.
• Disrupted sleep.

As there can be overlap between pre-labour and the start of labour itself, it's possible to confuse the symptoms of the two . How you'll feel in the pre-labour or early labour phases depends on: 

• Whether you've had a baby before.
• How you perceive and respond to pain.
• How prepared you are for what going into labour may be like.

Can I tell if labour is about to happen soon?

Maybe. There's a lot of overlap between the symptoms of late pregnancy and pre-labour, which is the time just before you go into the early first stage of labour. Signs that the birth may be on its way include: 

• Lightening, when your baby's head drops into an engaged position in your pelvis. You may be able to breathe more deeply and eat more, but you'll also need to wee more frequently, and walking may be more difficult.
• Heavier vaginal discharge with more mucus.
• More frequent and, possibly, noticeably more intense Braxton Hicks contractions.
• Mood swings.
• A sudden urge to clean or bring order to your home!

What should I do in early labour?

The early phase of the first stage of labour is when your cervix dilates to 4cm. The best thing to do during this time will depend on what time of day it is, what you like doing, and how you're feeling. Keeping calm and relaxed will help your body to release the hormone, oxytocin, that you need for your labour to progress. It can help you to cope with the contractions or tightenings. Do whatever will help you to stay relaxed. 

This could mean watching your favourite film, going for a walk, pottering around at home, or asking a friend or relative over to keep you company. You could alternate between walking and resting, or try taking a warm bath or shower to ease any aches and pains. If you can, try to get some rest to prepare you for the work ahead. 

During early labour, you may feel hungry, so eat and drink if you feel like it . Nibble on small amounts of high-energy foods to keep you going. This will help to comfort you and may even help your labour to progress more smoothly.

Early labour is a good time to try out different positions, breathing techniques and visualisations to see if they help you to cope with contractions. If you've got a TENS machine, early labour is the time to use it. It’s unlikely to help if you wait until you’re in active labour before you start using it.

How will I know when I've moved into active labour?

If you're planning to have your baby in a hospital or birth centre, the active phase of the first stage of labour is the time to go. This is where your cervix dilates from 4cm to 10cm. For many women, the main sign is painful, regular contractions. These gradually become more frequent, longer, and stronger in intensity.

Your midwife may have told you what to expect, such as contractions coming at least every five minutes and lasting at least a minute. However, for some women, labour progresses well without following a "textbook" pattern.

Listen to your body and watch out for how you're feeling. As labour intensifies, you're likely to talk less. You'll find holding a conversation during a contraction more difficult. You may notice that you have to pause as each surge builds, leaning forward and rocking your pelvis to help you through it. 

As your labour progresses, you may start to turn your awareness inward, focusing in on each contraction and using your breath to help you to cope. You might start "sighing" out from the start of each contraction.

As your labour gets stronger, your appetite is likely to wane, and you may feel hot and anxious. You may also and start to feel less inhibited and care less about what you're doing. This may help you to demand exactly what you need to help you cope!

When should I call my midwife?

You've probably talked to your midwife about what to do when you think you're in active labour. But if you're not sure whether the time has come, don't be embarrassed to call. Midwives are used to getting calls from women who are uncertain if they're in early labour or active labour, and who need guidance. It's part of their job. 

The midwife will want to hear about what you've been experiencing, particularly how close together your contractions are. She'll be able to tell a lot by the tone of your voice and how you respond to a contraction, so talking helps. 

It's not always possible for a midwife to accurately judge whether active labour has started over the phone. If you're using hypnosis or deep relaxation you may sound as though you're in an earlier stage than you are. That's why it's important to trust what your body is telling you as well as being guided by your midwife. 

If you're planning to have your baby in hospital or in a birth centre, you may not need to go in straight away. Instead, your midwife may give you some coping tips and advise you to stay at home until contractions become more frequent and stronger. Depending on what's available locally, she may arrange for a midwife to visit you at home, or ask you to come in so she canassess your labour.

Trust your instincts on when you think it's the right time to leave the house or call in the midwife. This may mean ignoring pressure from your partner, mum, or whoever else is with you, until you feel it's the right time to go. 

If you're going to hospital or a birth centre, always phone before setting off, as your chosen unit may be busy. If that's the case, the staff may ask you to stay home a bit longer or direct you to another unit. It's a good idea to prepare for this possibility so that it's not such a big disappointment if it happens to you. 

Ask your midwife how often your chosen unit has to divert women in labour and which unit they are usually sent to instead. Plan your route to your chosen unit and back up unit, perhaps even rehearsing the journey and checking out the parking at each one in the weeks leading up to your due date. This can take some of the anxiety out of the trip when you're in labour. 

When deciding when it’s time to leave, bear in mind that it can be harder to move as your contractions get longer, stronger and more frequent. Getting from your front door into your car may take a while as you pause for each contraction. 

Once your midwife sees you and can confirm you're in active labour, she will admit you to the labour ward, or stay with you if you're having a home birth. If she thinks you're in early labour, she's likely to encourage you to go home until you're in active labour. Her decision will depend on how you're coping and whether you've got a birth partner to give you good support. 

You should contact your midwife or doctor if: 

• Your baby's moving less than usual.
• Your waters break, or you suspect you're leaking amniotic fluid, so that you and your baby can be checked over.
• You have vaginal bleeding (unless it's just a small amount after a membrane sweep or the blood-tinged mucus of the show).
• You have a severe headache, changes in your vision, or sudden swelling of the face, hands or feet.

See our list of other pregnancy symptoms you shouldn't ignore, in case anything else is worrying you. 

You and your partner could also watch our video on how to help you understand pregnancy strains.

Can I have contractions and not be in labour?

Yes. You can have pre-labour contractions (Braxton Hicks). These help your cervix to go through the changes it needs to before it starts to dilate. Your cervix usually points towards your back, but as you start to dilate is will move forward. It will also be getting shorter and thinner (softening and effacing). 

These changes may take place over the last few weeks of your pregnancy without you noticing. Alternatively, you may experience hours or days of cramps or contractions. These may be helping the early changes in your cervix to progress, even though they may not be dilating your cervix yet. 

Your midwife can confirm whether your cervix has started to change by carrying out a vaginal examination. At your 40-week appointment your cervix may be firm and unyielding, while at the next appointment it may be "paper thin" and starting to open. 

If your baby has his head down but his back to your back (occipito-posterior position), it can take longer for his head to engage and for labour to start. Your contractions may be erratic and low in intensity, and you may have backache.

If your baby is back-to-back, getting onto all fours on your hands and knees, for half an hour or so now and again may help to relieve your backache. All-fours, forward leaning and lunge positions may also help your baby to turn to a better position for birth.

Your midwife will advise you about ways to cope at home until labour becomes stronger. You could take a dose of paracetamol, or try a warm bath or massage to relieve the pain. 

A long and uncomfortable pre-labour and early labour phase can be challenging. You may find that you need a different kind of support to the often-repeated advice to stay at home and use self-help. You may want to phone the labour ward again and go in for an assessment. The doctors there may prescribe you extra painkillers if you need them.



http://www.babycentre.co.uk/signs-for-how-I-will-know-I-am-in-labour#ixzz3ZGOXcmyx

Eczema and Baby

Concerned about dry, itchy, red spots on your infant? It could possibly be eczema. This blog entry will tell you more about eczema and how to help your infant cope with it.

• What is Eczema?

Eczema is a chronic itchy skin condition. Eczema usually starts within the first five years of life, most often in the first six months. It typically lasts into childhood and adolescence. In some cases it may last into adulthood. Eczema tends to wax and wane. There are periods of time where the skin appears mildly affected or even normal, alternating with periods of moderate to severe involvement. Some children have very mild eczema and others have severe eczema (also known as atopic dermatitis).

Eczema tends to be more common in families that have a history of eczema, hay fever, and asthma. These disorders are all a part of what is called the “atopic triad.” A first or second degree relative with a history of one of these atopic conditions can often be identified in the family of a child with eczema. Children with eczema may be more likely to develop allergies or asthma but one does not cause the other.

• What can trigger eczema?

Eczema flares occur when the skin is very dry, it comes in contact with irritating substances or allergic triggers, or when the skin is infected. Eczema tends to be worse in the winter when the air is dry and tends to improve in the summer when it is more humid. In babies, saliva from drooling may cause additional irritation, particularly to the cheeks, chin and neck. In such cases, applying an ointment like Aquaphor or Vaseline can prevent direct contact with saliva and decrease skin irritation. Specific triggers can vary based on the child and can include pets, carpet, dust mites, fabrics (such as wool), cigarette smoke, and scented products (such as perfume, laundry detergent and air freshener).
When the skin is infected your pediatrician or dermatologist may have to prescribe an oral antibiotic to improve the eczema.

• How do I treat eczema?

Unfortunately, there are no cures for eczema. Fortunately, in most children eczema becomes less severe with time. The good news is eczema can be controlled. Treating eczema requires treating both skin dryness and skin inflammation. A good bathing routine is necessary to treat skin dryness. Anti-inflammatory medications, like topical steroids or topical calcineurin inhibitors (TCIs), are used to treat inflammation. Occasionally, oral anti-inflammatory agents are needed to treat the most severe cases.

• Bathing a child with eczema

Daily bathing is recommended for infants and children with eczema. Baths are generally preferred over showers. Baths should be warm, not hot, and they should be short in duration, lasting about 10 minutes. The use of soap should be limited. Bubble bath, epson salts, and some other bath additives should be avoided because they can be irritating to the skin and worsen eczema. Also avoid the use of scrubbers, loofahs, and rough washcloths. Immediately after bathing, a moisturizer should be applied to the skin.

Dove© bar soap for sensitive skin, Stelatopia Cream Cleanser, Cetaphil© Gentle Skin Cleanser, and CeraVe© Hydrating Cleanser are examples of cleansers often recommended by dermatologists to treat eczema. Cleansers should only be used to wash the diaper area and areas that appear dirty. They do not need to be used on a daily basis.

• Moisturizing a child with eczema

 Moisturizers should be applied at least twice daily—in a thick layer. Generally two types of moisturizers are recommended for treating eczema: ointments and creams. Lotions are mostly water and are not recommended. It is most important to moisturize the skin immediately after bathing (within 3 minutes) to prevent evaporation of moisture from the skin. Ointments and creams seal moisture from the bath into the skin, much like plastic wraps seal moisture into a cake.

Moisturizers are classified based on their oil and water content. The more oil a moisturizer has the more effective it is in treating dry skin. Ointments have the greatest oil content, followed by creams, and then lotions. Creams and lotions also often have added preservatives that may burn when applied to scratched open skin. Ointments usually do not burn when applied. Ointment-based emollients and medications are generally preferred over creams for these reasons. Lotions are not generally recommended. During the summer a cream may be preferable to an ointment to prevent miliaria (prickly heat), which can occur after application of an ointment in the summer heat and humidity.

To prevent skin irritation, seek out moisturizers that are fragrance- and dye-free.

• Shampooing a child with eczema

Most gentle baby shampoos can be used. Fragrance- and dye-free shampoos are preferred. The fewer the ingredients, the better. One example is Exederm™ Baby Eczema Shampoo. 

• Will changing my child's diet help?

While many parents assume that a particular food is the cause of their child’s eczema, the answer is rarely that simple. Most eczema is unrelated to diet. In fact, parents who remove food from their child’s diet in an effort to clear up the skin can be causing more harm than good. If your child’s eczema greatly improves with gentle skin care and topical medications as described above, it is unlikely that there is a “hidden” food allergy in play.

Some children with eczema have food allergies, but that does not mean that the food allergies actually cause the eczema. If your child gets hives (red, itchy swollen skin bumps that look different from eczema) within one hour of eating a specific food, this is a sign of a food allergy and this food should be avoided until you talk to your child’s doctor.

Most infant eczema is unrelated to diet, whether breast milk or formula. Many babies with eczema are incorrectly labeled as “milk allergic.” Do not stop breastfeeding or giving cow’s milk formula without first talking to your child’s doctor. In most cases the skin will improve by using the gentle skin care techniques and topical medications described above.

Sources: National Eczema