Tuesday, September 10, 2013

Tearing down there!

When giving birth a large percentage of women will have tearing in the perianal area (the area between the vagina and anus).  Episiotomies were the standard procedure for many years but they are now only done when a forceps or vacuum delivery is needed and then only when necessary. 

During my labor I had a 2 degree tear which means I have a giant paper cut on my tush.  In more medical terms here is the breakdown of the degrees of tearing.

·      First degree:  Tearing of only the skin around the perineum.  This tearing usually requires stitches and heals fairly quickly.
·      Second degree:  Tearing of the skin and muscle tissue in the pelvic floor.  This will require stiches of each layer (stiches are dissolvable), will take weeks to heal and does cause more discomfort.
·      Third degree:  Tearing that involves the muscle and skin but extends to the rectum and can even include the anal sphincter.  This can be uncomfortable for months and can cause some incontinence.
·      Fourth degree: Tearing that involves the muscle and skin but extends to the rectum and can even include tearing completely through the anal sphincter to the tissue below.

Tears most often occur if:

   This is your first vaginal delivery.
   You've previously given birth vaginally and had a third- or fourth-degree tear.
   You have an assisted delivery, particularly if forceps are used.
   You have an episiotomy or you had one in a previous delivery.
   Your baby is big.
   Your baby is born in the posterior position (face-up).
   You push for a long time.
·      The distance between your vaginal opening and anus is shorter than average.

Once you have tearing how do you treat it?  The most common way is to use witch hazel pads called Tucks.  The hospital will usually provide these to you.  Unfortunately I found out that not only am I allergic to witch hazel, but some of the other ingredients in Tucks.  

One technique I learned is to do sitz baths using loose leaf or bagged varieties of the sitz bath and doing a light soak.  The best technique is to do what is called a pad-sicle.   A pad-sicle is where you soak a maxi pad in water or witch hazel and place it in a bag and freeze.  It is wise to do this before baby comes so that you have several in the freezer. Then even if you have a mild tear you can ice the area and then dispose of the pad as bleeding will be present from your uterus.  I loved putting ice on this area with a gentle barrier.  It felt amazing. 

Thursday, September 5, 2013

Breast Trouble

Some of the many things that can happen to a new mom when breastfeeding are mastitis, plugged ducts, yeast on the nipples and low milk production.  Combine this with fatigue and taking care of a new baby and any one of these can be enough to tempt you to give up breastfeeding. 

Unfortunately I have had to deal with mastitis as well as a plugged duct.  In fact a plugged duct often precedes mastitis since it means that a milk duct isn’t draining allowing an infection to take over in that duct.  Mom then gets a fever, fatigue, flu- like symptoms and a red streak across the breast. 

There are some natural ways to prevent and treat both if you catch them in time.  However, if you don’t catch it quickly then you may need an antibiotic.  This doesn’t mean however that you can’t get another infection or round of mastitis as I did.  So you will want to take supportive measures along with the antibiotics. 

I took Dicloxacillin for the first round.  I got a second infection while on the antibiotics meaning that the antibiotic was not effective in treating the infection. They gave me a different antibiotic (Cephalexin) my third time around.

For natural support and to prevent getting another infection I also am taking:

·      Lecithin Granules helps with milk flow from the ducts and can prevent further plugging.  Talk to your doctor about which form is best for you.
·      Grapefruit seed extract -- natural anti- yeast/bacteria.  Please check with your doctor as not all women can take this.
·      Fenugreek to boost milk production

Always remember taking care of yourself is important and absolutely necessary if you are going to breastfeed because a sick body won’t produce enough milk for baby.