The birth of a baby is a joyous occasion. However, in the postpartum period the new mother may face a host of potential problems. These include the physical problems of fatigue, anemia, pain (from the episiotomy or Caesarean section), and breast soreness. Mental disturbances such as the "blues" or postpartum depression are also well-recognized. These complications usually occur soon after the baby is born, and by the third month after delivery most women are feeling well. Unfortunately, that is not always the case and some women do not enjoy a rapid return to good health. In the past few years, it has become apparent that some of these women are ill because of postpartum thyroid disease, and may be helped to feel better with proper treatment.

A new Center for Disease Control report finds that an estimated 375,000 babies being born each year at risk of neurological problems due to exposure to mercury in the womb. The Mercury Policy Project report indicates that at least 10% of women of childbearing age have levels of mercury in their bodies that exceed what the U.S. Environmental Protection Agency considers acceptable - this translates to nearly six million women. In addition, the FDA has issued advice on mercury in fish bought from stores and restaurants, which includes ocean and coastal fish as well as other types of commercial fish. Women who are pregnant or could become pregnant, nursing mothers and young children should not eat swordfish/marlin, Ahi, king mackerel, shark (often sold as imitation crab), or tilefish.

Cows' Milk, Lactose Intolerance
Since lactose is found in mother's milk, almost all infants of nursing age are able to digest it. But past weaning and with increasing age, progressively fewer children retain this ability. One study of black children found lactose intolerance in 11% of four- to five-year-olds, 50% of six- to seven-year-olds, and 72% of eight- to nine-year-olds. It is usually rare among North American white children under six years of age, but increases to 30% in adolescents.

"Most formula-fed infants developed symptoms of allergic rejection to cow milk proteins before one month of age. About 50-70% experienced rashes or other skin symptoms, 50-60% gastrointestinal symptoms, and 20-30% respiratory symptoms. The recommended therapy is to avoid cow's milk." [Pediatric-Allergy-Immunology, August, 1994]

"Those who consumed cows milk were fourteen times more likely to die from diarrhea-related complications and four times more likely to die of pneumonia than were breast-fed babies. Intolerance and allergy to cow's milk products is a factor in sudden infant death syndrome." [The Lancet, vol. 344, November 5, 1994]

Infrequently, severe cases of lactose intolerance in children have been shown to cause damage to the lining of the intestine and severe diarrhea.

Milk Production
Most problems with insufficient milk supply result from issues with breastfeeding during the first six weeks, when a mother's milk supply is being established. A reduced milk supply may result from an insufficient number of feedings, limiting length of feedings, or improper positioning at the breast.

There are also maternal factors that have been associated with insufficient milk supply. Some medications, such as birth control pills, antihistamines and sedatives may decrease the milk supply. Smoking, excessive caffeine intake (more than 5 cups per day), hormonal problems and fatigue have also been associated with poor milk ejection reflex.

Although uncommon, a mother may be born with insufficient glandular tissue. Breast surgery, especially breast reduction, can have a similar effect.

Babies themselves can also play a part in insufficient milk supply. A baby with a tight or short frenulum (tissue anchoring the tongue to the floor of the mouth) may not be able to nurse properly, unless it is clipped.

Weight loss after pregnancy
It can be difficult to loss weight if there was too much weight gain during pregnancy. Fat deposits,during pregnancy, can increase by more than a third of the total amount a woman had before she became pregnant. If the weight gain was normal, most women lose this extra weight in the birth process and in the weeks and months after birth. Breastfeeding helps to deplete the fat deposited during pregnancy. A woman who breastfeeds expends at least 500 more calories than one who doesn’t. The woman who nurses her baby also has increased needs for specific nutrients, and should not be on a weight loss diet.

Should you breastfeed while pregnant?
As a general rule, if it’s safe for you to have sex, it’s safe for you to breastfeed. There are, of course, legitimate reasons why certain mothers may be advised to wean -- and abstain from sex -- when they become pregnant (such as those with a history of preterm labor, premature delivery, or miscarriage, women who experience uterine pain or bleeding, and others with the potential for higher-risk pregnancies). But for most mothers, breastfeeding while pregnant is perfectly safe. In fact, in many regions of the world, women routinely breastfeed one child while pregnant with the next.

Vaccinations
Whether to vaccinate or not is a controversial and complex subject. There are many websites dedicated to informing parents regarding this issue. Many states accept vaccination waivers based on religious grounds and samples of religious waivers are available on the Internet.

Here are some guidelines to assist you if planning to have your child vaccinated:

• The older the infant, the better. Delaying vaccination reduces the likelihood of negative consequences.
• The healthier the infant, the safer. Don’t vaccinate when the infant or child is ill.
• Blood type suggestions, for those interested in the "Blood Type Diet":
  • Blood Type O children: Be alert for any sign of inflammation (fever, joint pain). Avoid injectable polio and use the oral version instead since type Os seem to need a less potent form. Don’t give acetaminophen (Tylenol) for vaccine-related problems, as type O children seem to do poorly on it.
  • Blood Type A and AB children: They respond well to vaccines and a full program should produce few side-effects. Use the injectable instead of the oral polio vaccine as digestive mucus does not react well to the oral vaccine in these blood types.
  • Blood Type B children: Sometimes type Bs have neurological reactions that may occur as a result of cross-reactivity with the vaccine, resulting in the body attacking its own tissues. Be alert for any crawling or personality changes and make sure they are completely healthy before vaccination. As with type Os, use the oral polio vaccine.
• The likelihood of severe reactions can be reduced by giving 500mg of vitamin C just prior to the vaccination. If convulsions occur within a day or two after vaccination, Vitamin C should be given by injection. [Journal of Orthomolecular Medicine, Third quarter 1999; 14(3)]

Australian health professionals have raised concerns that controlled crying, also known as controlled comforting and sleep training, may have a negative impact on the emotional and psychological health of infants. Controlled crying involves leaving a crying baby for increasing periods of times before coming to comfort them in an attempt to teach them to put themselves to sleep and not cry out during the night. The researchers say that it is normal for babies and young children to not sleep through the night, and their crying is a sign of distress. Although controlled crying may teach children to stop crying, it may also teach them not to seek help when they are upset. [Australian Association for Infant Mental Health October, 2003 ]

SIDS - Sudden Infant Death Syndrome

A study released this week (Oct 9, 2008) by the Archives of Pediatrics & Adolescent Medicine, found that having a fan going in the room where a baby sleeps decreases the chances of Sudden Infant Death Syndrome (SIDS) by a startling 72%.

Doctors reportedly don't know all the reasons why this seems to work, except that improving circulation of the air in baby's room (though not blowing directly on the child) is important since the infant's neck muscles are not strong enough to always turn his head toward fresh air. Exhaled carbon dioxide can build up, says the study, between the baby's face and the mattress, causing him to re-breathe that used air.

The research needs further study, says Marian Willinger of the National Institutes of Health, and she reiterates that putting a baby on her back to sleep is still the most important way to prevent SIDS.