Motto 2013

It's winter, year 2013 had just begun and between being lost in between falling flakes of snow I am asking myself, how many babies, how many children is happy?

Do we realize that these babies didn't want to get on this world? They weren't in a hurry to get to this world, we gave them the life...but by giving the life our responsibility doesn't end. We should support them, guide them, form them on this road of life using our best intentions and feelings. We should create a supportive environment for their current life and the future one that will became current with a blink of an eye as well.

Dear parents, our children grow incredibly fast. It would be mainly our waste to loose the most precious time that your life can offer you. From some reason You were suppose to become parents, so take it as a gift not a curse and try to be the best – not in the whole world, but just for your children.

Faithfully Yours Nanny B.

The reason for repeated failed coneption might be increased prolactin production

Prolactin is a hormone that control many chemical processes in body. The most important and key process is the lactation initiation. Another not less important is during the strong mother – child bond creation which failure can cause possible mother absence for a little child. 

In normal life prolactin doesn’t play such an important role. It production is major during night time mainly in REM sleep stage. During daytime it is mainly used during the psychical balance disturbance and coming stress situation. It means that its main purpose is to get the organism ready to cope with an upcoming stress situation. The place of its origin is the hypophysis in brain.

Hyperprolactemy – it is an increased prolactin level contained in blood. This increased production mostly causes menstrual cycle disturbances where usually goes completely away. This is caused by the prolactin’s effect that blocks eggs grow process (This is a main cause in the 10% of the cases).

Precautions in hyperprolactemy

If the woman fails to conceive it is necessary to perform some examinations before the treatment process itself. These examinations include blood tests. Blood test for the prolactin level should be performed during morning time approximately 2 hours after the wake up when the physiological prolactin level is still low and does not distort results. If the high prolactin level is confirmed the treatment follows. The treatment is usually in form of pills that lower the prolactin level.

For some women it is possible to determine clear cause of the trouble. This cause is usually non-benign cancer of the hypophysis in brain. If the tumor is smaller than 10cm (3.9inch) it is the microprolactinom. Tumor bigger than 10mm (3.9inch) is called macroprolactinom. In this case the pharmacological treatment is used as well. This treatment not only leads to lowering the level of created prolactin but also the total amount of prolactin in the body. In more rare cases, where the pharmacological treatment is not successful is possible to use radiotherapy using Laksell´s gamma knife.

How to recognize higher production of prolactin? (Hyperprolactemy)

·         Menstrual disorders (total disappearance of menstrual cycle)

·         Problems in conceiving

·         Sensitivity and pain in the breast area

·         Secretion from one or both breast

How to recognize lower production of prolactin? (Hypoprolactemy)

·         Usually not even recognized

·         Troubles with the beginning of lactation (or no lactation at all)

Because prolactin is a stress hormone, it is true that the more woman is stressed out the more prolactin level increases and with longer periods of these episodes the issue can become chronic. That’s why the best prevention for the infertility caused by any reason is the calm and well balanced environment.

Another reason for infertility might be endometriosis

Endometriosis is the common reason for the women infertility. It is a chronic disease characteristic for its endometrium outside of the vaginal area. It is quite a common disease that affects approximately 5-10% of women population in reproductive age. Up to 70% is recidivist.

Endometriosis symptoms:

·         Irregular painful menstruation

·         Pain during sexual intercourse (can lead to its refusal)

·         Chronic pain of stomach

·         Fertility issues

Endometriosis and infertility

One of the complications of endometriosis is the lowered throughput of fallopian tubes and lower production of ovulocytes in ovaries that can lead to the total infertility. Endometriosis occurs in 7-10% of women in their reproductive age.  Incidence for women that are already treated for infertility is 6-8 times higher.

Endometriosis treatment

Endometriosis is hormonally dependent illness and so the primary treatment should always be hormonal. If needed the solution is always to undergo a surgical treatment or use analgesics treatment that should be just a supplementary treatment for hormonal treatment.  

Main target for the hormonal treatment is to temporarily cancel menstruation and thanks to that suppress the endometrium growth outside of the vaginal area. This will lower and eventually kill the core cells of the endometrium outside of the vaginal area. If this procedure is successful the woman health state will rapidly improve.

At present day there is no way to completely cure endometriosis. According to recent statement of American Society for Reproductive Medicine endometriosis should be assessed as chronic illness, requiring all life therapeutical plans having in mind maximum use of pharmacological means and limited repetition of surgical procedures.

The most common reasons for infertility:

·         Disturbances in menstrual cycles, with amenorrhea – when woman will stop menstruating in the time of her menstrual cycle

·         Syndrome of polycystic ovaries – excessed number of little follicles is produces in ovaries, that are not able to fully grow thanks to the hormonal misbalance

·         Hyperandrogenal syndrome – increased level of man hormone

·         Post pill amenorrhea – long time use of hormonal protection that can lead to the loss of menstruation

·         Women that are extremely thin or with excessive overweight or physical load (professional sportswomen)

Ovarian function failure

Ovarian failure is an ovarian function failure for women before their forties.

The lowered function of the ovaries tissue can be caused by the repeated ovarian operation (when removing cysts from ovaries endometriosis)

Morphologically conditioned infertility

This type of infertility is usually connected with the lowered throughput of the fallopian tubes. These are usually caused by gynecological inflammations (adnextidis), after repeated stomach operations and also for other than gynecological reasons (for example Crohn disease). Morphologically conditioned infertility can start from endometriosis.

Congenital infertility

Is usually caused by Turner´ syndrome, where the woman is missing one genital chromosome X, which causes that ovaries are not fully evolved and can´t fulfill their natural function.

Immunological infertility

Immune system of some women creates antibodies against the man´s sperm or against own ovaries. These antibodies are the main reason for infertility.

Drugs effect

Problems with conception can be also caused by some drugs. For example “The syndrome of uncracked follicle” where the egg is not released from the mature follicle. This might be caused by some painkillers (inhibitors of prostaglandin synthesis).

Name influence

Names were created for the reason to name call and individualize and distinct from the others. It used to be common that the individual was given a name once he was able to show his abilities and skills and his name was very close and related to him and his abilities.

These days the attitude is different the name is given usually right after birth and is decided some time before the birth. This name thus carries the wishes and presumptions to strengthen and support something with this name. It thus carries parent’s wishes and does not specify the one’s skills and abilities.

Name itself caries certain energy and potential. With the constant repetition of the same vowels and same sounds with the same vibrations when speaking out our name we get used to these sounds and we embrace it as our own. Repeated sound when saying our name or signing ourselves has a great influence on us. Selected name has also an influence on baby’s psychological and health state and so it is very important to select it carefully and patiently. It expresses its personal characteristics and uniqueness that accompanies him every day. It is also important to carefully combine the first name with the surname either our maiden name our new name after our partner. So with this decision we are partly creating ours children future and it very good to realize it, before we make a final call.

It is definitely not a great decision to pick the name by some movie star, politician or band player. As well as it is not recommended to keep the name between generations, of course there is an exception for this rule if we love the name and we are sure it is the one for our child.

It is usual that parents tend to give the name that is kept in the family for generations and later are sad that they weren’t strong enough and didn’t pick up differently because the baby is as angry and aggressive as it’s grandpa used to be and it doesn’t make sense that such a young baby is so aggressive.

Because we didn’t thought the name selection through and the child’s satisfaction with this selection we could cause all of this anger ourselves. Let’s wish to have happy and healthy children, to look forward to them. We want to give them the best. We begin with the effort to give him the right name, the call that it will carry for the rest of the life.

Mother that carries the child under its heart can intuitively feel what name would be appropriate or what name the child had picked up already.
Since the third month of pregnancy it is not just an embryo but it is a living creature with own destiny and universe past that demands to have the right name for its future related to its personality. Unique vibrations imprint’s child’s name into mother’s mind and it is important she will listen to the child and not to grandparents, friends or other outside influences in that matter.

The best is when the mother has a feeling that the baby picked up on its own and is satisfied with it. It is best to give the baby three names because person as a human being consists from three parts – body, soul and intellect. The first name connected to the body part should become commonly used main name.

It is very appropriate to look at each name complexity because every name has its colour, its resonance, characteristics and it is not recommended to give to a nervous and impatient child the name that would only support such personality.

And the baby will not like this name as it would support something it has already in a strong form and then will attach to its surname that would pass on him the ancestral issues.

Nomenology doesn’t distinct good or bad names but distincts “strong” and “weak” names where the strong name does not need to be appropriate and beneficial for its owner. Strong names are the names that have strong nomenological potential and energy. Weak names are names that doesn’t give or require much, they don’t carry any message but defines a certain fact. Strong name offers a lot but also requires from its owner quite a lot. It is a great task for him to carry such name and it is not everybody would keep up with such a task.  If the name doesn’t naturally resonates with its owner and the owner doesn’t have enough of the inside potential the balance is disturbed and the energy turns against it owner.

Sometimes the dissatisfaction with the name leads to the replacement with another one which is quite dangerous because the change of the name carries the beginning of another life. The previuous name stays in the past. Sometimes the decision to such step brings many benefits and makes a hope for a better life.

Breast pump

Great modern helper for many mum's around the world

Not every woman is that lucky to have her lactation as expected. For mum's who doesn't have enough of the milk the breast pump is a great help that stimulates the breast properly and helps the milk production.

The market offers several breast pump types, electric or mechanic. It is a great helper that comes in handy in the times of little because it helps to stimulate and create more milk and in the times of more where it helps to put the milk into bottles to freeze the extra milk for later use.  

Breast pump types

Pump type	Description	Image
Mechanical pump	Mechanical pump is recommended for mothers with normal lactation but needs time to time relax their breast before breastfeeding or after.
Mechanical balloon type
Mechanical leveler pump
Electrical mini pump	Mini electrical pump is recommended for breastfeeding mothers with big lactation but has so much milk that they need to squirt it out and relax the breast.
Electrical hospital pump	Hospital electrical pump is recommended for non-breastfeeding mothers but daily squirt a full dose of milk.
One phase pump	One phase milk extraction system introduces save and careful milk extraction for mothers who’s lactation is without a problem. All one phase pumps have vacuum regulation and ensure comfortable milk extraction.
Two phase pump	Two phase milk extraction system (ES) nearly fully resembles baby sucking rhythm, first stimulation phase and second lactation phase. Two phase milk ES is very careful to the breast. It is recommended for mothers that needs to start the lactation after birth so the baby can get the mother's milk as soon as possible after birth. This pump is also suitable for mothers who can't for any reason breastfeed after birth. It was tested and proven that these mothers had their own milk after 30 hours of using the two phase pump.

When to extract, when to squirt?

•   It is necessary to use the pump for premature baby that is not able to suck from the breast. An ideal type of pump to do this job is the big electrical hospital breast pump, that can perfectly simulate child's sucking reflex. It is possible to continue with smaller electrical home pumps after the lactation had started. The extraction should be regular. During the day in 2-3 hours intervals, in the night 2x, every breast 10-15minutes. If the baby was born very early or has some health issues the milk extraction can be a matter of many weeks or months. But it is definitely worth It because especially prematurely born babies needs mother's milk from their own mother, which consistency adapts to the needs of the baby.
• If it is necessary to stop the breastfeeding for some urgent reasons. For example mother's or baby's health issues. It is possible to keep the milk extraction. Milk should be still extracted in the same time intervals, as the baby was fed before and should be given to the baby in an alternative way (spoon, syringe,... ).
• Planned separation – can be for couple of hours or days or even can be regular when the mum is partially employed or study. Or if she needs go to the planned operation. It is advisable to prepare the milk for these occasions. In the time when the baby is not fed it is necessary to squirt the milk every 3-4 hours (this applies for fully fed babies, older babies that has partial solid food don't require it so often) to prevent the milk from solidification.
• Even for babies that don't corporate during breastfeeding it is possible to keep all the breastfeeding benefits. The baby is fed from the bottle. Woman can keep the lactation for a very long time, more then a year by using electrical pump (Ideal is both breast pump). Breast milk extraction frequency and interval is controlled by the woman herself. Some women collect the milk for their baby during for extractions other needs twice the amount.
• It is highly recommended to relax the breast with a milk excess, that can result in retention or breast inflammation. If even after the feeding there are solid places in the breast it is necessary to release the pressure from these places and squirt the milk out (by pump or hand). If the woman will squirt the milk every day less and less then the lactation will adapt to the child's needs.

• If the milk squirts out during first weeks very strongly and the baby is choking on it, it is recommended to squirt a bit of a milk out and that will cause the milk flow to slow down. Also when the breast are to full with the milk it is hard for the baby to catch the breast. It is recommended to massage areola and squirt the milk out.

Appropriate time to extract the milk is after the breastfeeding or in the longer pauses between breastfeeding.

There are number of breast pumps on the market these days. It depends on the need and use but generally I would recommend the brands Avent, NUK and Maleda. Good luck with or without the pump and a lot of full and happy babies.

Faithfully yours Nanny B.

Breastfeeding twins

It is definitely not an easy task, but it is feasible and worth it.

Benefits for your babies:

1. Breast milk protects your children against infection. Milk produced right after birth is full of vital proteins and antibodies that helps the child to grow up properly and healthy. These proteins and antibodies also protect your child against intestinal and other after birth imminent infections and lower the risk of the allergic reaction,
2. breast milk is a very important part of the baby nutrition until the age of 2,
3. breast milk is especially suitable for extremely small or premature babies, which are more vulnerable to diseases and have more trouble digesting artificial dry milk. Quite a lot of twins sadly falls under this category,
4. breastfeeding creates strong and nice bond between mother and her children

Benefits for you (mums):

1. Breastfeeding helps you to feel better and more happy because of Prolactin hormone, which is one of the hormones being produced while feeding that has calming and relaxing effects – which is especially valuable for twins mum,
2. breastfeeding is emotionally rewarding. Mothers knows that they do the best they can for their children and that they literally give the best out of themselves,
3. in compare with artificial feeding breastfeeding is easy. There is no need for bottle sterilization, dosage estimation, heating, or trust issues with unknown artificial milk brands,
4. breastfeeding is cheaper,
5. breastfeeding can be fast. With the knowledge of the right technique you will spent the same time feeding twins as feeding one child. We will go over these techniques in following chapters.

The most important thing when breastfeeding twins is the HOPE

You just need to believe and everything will be fine. You don´t have to be afraid that you might not have enough of the milk, breastfeeding is the matter of offer and demand, the more children will consume the more milk will be produced in the breast. The important things for mums are the proper time of eating, proper rest, no stress environment and following of systematic order.

Proper breastfeeding technique

Mum should take the breast between the thumb and other fingers and put the nipple to the child's mouth and with slow circular movements try to invoke the sucking reflex. Widely open child mouth as if yawning are the proper response to this stimulation. Any touch in the facial area and mainly around mouth provoke this reflex in babies 3 months and younger. Baby is turning it's head from side to side and opens the mouth widely. When we circle the baby's mouth with the nipple we help to find the mouth it's place. If the baby is opening the mouth as in yawning we swiftly put the nipple and big part of lower areola in it's mouth. The nipple inside of the child's mouth touches the upper palate with the sensing point that invokes sucking reflex.

Frequent breastfeeding

The sensitivity of the nipples will lower thanks to the frequent breastfeeding which will positively stimulate the milk production

Breastfeed together or separately?

When breastfeeding together it creates a strong stimuli for the milk production. What is not such an easy task is to coordinate the same time of the breastfeeding. Generally is better to breastfeed both twins together.

Which breast?

The best situation is when each child has it's own breast because the milk will adapt to it's unique requirements and produces the substances in the right amount and composition that the child needs. If ont of the child is weaker (smaller) it is good to change the breast, because this child will most probably not have sucking reflex strong enough and with breast changing is possible to stimulate both breast sufficiently.

Breastfeeding child positioning

This position is dificult but possible. It is rather used for babies distraction, when they do not want to suck the milk. It is used very rarely.

Football player position (the most popular)

Tandem position

Cross position

Breastfeeding cessation

Based on your own decision you can breastfeed your children for several months or longer then a year. If you will even after repeated countermeasures loose milk you can decide to end the breastfeeding and still be happy that you have provided the best out of you for your children.