'parenting' posts

In the haze of joy and sleeplessness during the months after childbirth, thoughts about breast cancer are the last thing on a new mother’s mind. Her body is undergoing so many changes that, of course, she and her doctors would naturally assume any breast changes are related to breastfeeding.

Probably, they are. However, there is a small but real incidence of women who develop breast cancer during and following pregnancy. Often, they end up having delays in seeking evaluation and getting a diagnosis, because they or their doctors may not appreciate that risk!

So, what things should prompt an evaluation?

• Lumps most often will be changes in the breast tissue as it revs up milk production. A distinct lump or “dominant mass” could be a clogged duct, galactocele, cyst or a common benign tumor called a fibroadenoma, but if it doesn’t resolve within a few weeks with treatment, it needs imaging.
• Redness most often will represent infections like mastitis or an abscess, but if it doesn’t resolve within a few weeks with treatment, it will also need imaging and possibly a biopsy. At the very least, that could determine if the right antibiotics are being used. An uncommon form of breast cancer called inflammatory breast cancer can present this way.
• Bloody milk or baby refusing one breast  most often will be due to nipple trauma, latch issues, or positioning; if so, seeing a board-certified lactation consultant is appropriate. But rarely, this can represent a form of breast cancer within the milk ducts.
• “Something’s not right”. You are the most knowledgeable person about your own breasts. Even if it doesn’t neatly fit one of the categories above, if something really seems wrong to you, your doctors should take that seriously.

What evaluation should be done?

A lot of parents have questions about the flu vaccine and many parents refuse the vaccine as they feel it does not very effective. Some parents are concerned about vaccines in general and refuse vaccinating their child as they don’t want to administer “another vaccine” to their child. The best way to prevent getting flu is by vaccination.

What is flu (Influenza)?

Flu (influenza) is not just a common cold or a stomach virus as most people think. Influenza usually occurs during the winter in our region although it can occur all year around in other parts of the world. It can be a serious respiratory illness that can lead to complications especially in children and older adults. Symptoms are generally similar to any other common cold infections and can vary from fever, runny nose, nose congestion, cough, body aches and headaches. The body aches and headaches are mostly reported by older children and adults. Children may not be able to explain their symptoms and may just be fussy.

Most children get over the flu without any complications. In some children and adults, however, it can lead to serious complications including pneumonia.

How to prevent the flu:

Influenza is ...

Umbilical cord blood banking is a procedure where your OB takes some of the blood (and now tissue) from the placenta and umbilical cord after your baby is born and the cord has been cut. You may never have thought about what we do with that stuff.

What happens to your baby's umbilical cord?

In the past, it has usually been discarded as medical waste, although some women want to take it home with them. Over the last two decades medical advances have been developed in which the cells from that blood can be used to treat several diseases. The cells have unique characteristics that allow them to change into a multitude of different cell types (called pluripotent cells.) The idea is that some children and adults with certain genetic abnormalities or certain cancers can benefit from these cells. The cells can be grown to replenish the normal cells or treat abnormal cells.

The options for umbilical cord banking are divided primarily into what’s called public and private cord blood banking.

Private cord banking

Private cord banking is just what it sounds like: we collect the blood at the time of your delivery and you send it to a business that processes it and stores it for you. The cost of this varies currently from somewhere between $2000 and $3000 for initial processing and from about $120 and $300 per year to store it. In this case, you are storing the cells for yourself and your family.

Public cord banking

Alternatively, public cord banking is something anyone who delivers at certain hospitals has the opportunity to do. There is a public cord blood system that has been growing since 1990 that is similar to the blood bank and is used for individuals who need the blood due to illness or injury.

At Swedish, all patients can donate cord blood to the Puget Sound Blood Center. The cord blood collected for this bank is available to all individuals based on need. The cord blood collected is not specifically available to the individual who donated it. We are happy to collect blood from all families, but are finding increased needs in patients who are ethnic minorities or a mixed race couple. The cord blood also can be directed to Fred Hutchinson Research Center for ongoing research regarding current and future treatments.

Isn't cord blood banking controversial?

There are ...

SEATTLE, Oct. 15, 2012 - If you’re pregnant or thinking about having a baby, finding the right provider is a pretty good place to start this incredible journey. When you come to OB Speed Dating, you’ll get the chance to meet several Obstetricians and Certified Nurse Midwives (CNMs) who deliver at Swedish/Ballard's Family Childbirth Center and get to know them in a fun, low-key environment.

The most common thing that I see as a pediatric surgeon is a child with a lump that is thought to be a hernia. A hernia is a bulging of tissue through an opening in the muscle layers that isn’t normally present. In children, these openings are usually the result of a developmental process that just didn’t quite reach completion. Some hernias need surgery emergently, while others are observed for years with the expectation that they will close on their own.

Here are some pointers to help understand this wide range of approaches to hernias:

Location is very important in considering how aggressive to be with hernias. Belly button (umbilical) hernias are...

As a pediatric surgeon with a special interest in intestinal issues, I am often contacted by worried parents regarding their baby's infrequent bowel movements. This can be caused by a variety of
problems such as blockages of the intestines or abnormal intestinal function (including a condition called Hirschsprung's disease); but most frequently babies are just efficiently absorbing and thus not needing to poop very often. This is especially true for breastfed babies. So, how can a parent tell the difference?

I would offer the following "red flags" as issues that may indicate a problem needing further medical evaluation:

The area is heating up. The National Weather Service has announced an excessive heat watch for this Thursday and Friday, with temperatures that will rise into the low to mid 90s. When outside temperatures are very high, the danger for heat-related illnesses rises. Older adults, young children, and people with mental illness and chronic diseases are at particularly high risk.

Here are some safety tips to avoid overheating and things to consider for the weekend:

Stay cool:

• Spend more time in air conditioned places. If you don't have air conditioning, consider visiting a mall, movie theater or other cool public places.

• Cover windows that receive morning or afternoon sun.

• Dress in lightweight clothing.

• Check up on your elderly neighbors and relatives and encourage them to take these precautions, too.

Drink liquids:

• Drink plenty of water; this is very important. Avoid drinks with caffeine, alcohol and large amounts of sugar because they can actually de-hydrate your body.

• Have a beverage with you as much as possible, and sip or drink frequently. Don't wait until you're thirsty to drink.

If you go outside:

• Limit the time you're in direct sunlight.

• Do not leave infants, children, people with mobility challenges and pets in a parked car, even with the window rolled down.

• Avoid or reduce doing activities that are tiring, or take a lot of energy.

• Do outdoor activities in the cooler morning and evening hours.

• Avoid sunburn. Use a sunscreen lotion with a high SPF (sun protection factor) rating.

• Wear a hat or use an umbrella for shade.