So how exactly can breastfeeding be beneficial?

1. Illness prevention. The nutrients in a mother’s breast milk are designed exclusively for her baby—and that’s something formula just can’t reproduce. Babies who are breastfed are less likely to suffer from ear infections, stomach viruses, meningitis, respiratory problems and other illnesses, and when they do get sick, they tend to recover faster. This is largely thanks to a substance in breast milk known as immunoglobulin A, which creates a layer over the mucous membranes of the nose, throat and intestinal tract, helping protect them from harm. Children continue to benefit from a bolstered immune system later in life, even after breastfeeding has ceased. They’re at a lower risk for some childhood cancers, diabetes and high cholesterol, among other diseases.

2. Cost savings. Formula isn’t cheap. And while you may purchase a breast pump and other accessories—like nursing tops and pillows—to aid you, it’s likely to come out to be less in the long run than the price of formula and bottles. Don’t forget the potential savings when it comes to health care costs, too.

3. Allergy protection. Formula-fed babies have more allergic reactions. Scientists think that the same protective layer provided by breast milk that helps guard against diseases also steels the body against allergic reactions. With the protective coating of immunoglobulin A around the inside of the intestines, allergens are less likely to penetrate through. By getting only breast milk, babies also aren’t exposed to the allergens that can come with cow’s milk or soy milk.

4. Bonding. Many moms find nursing to be one of the best ways to bond with their babies. Mothers who nurse hold, speak to, and rock their babies more often (even when not feeding). The skin-to-skin contact helps form a strong connection, and research has shown that hormones released while breastfeeding increase a woman’s feelings of love and affection.

5. Increased intelligence. Although the question of whether breastfeeding boosts brainpower is debated, it certainly can’t hurt. Studies have found that vocabulary and cognitive development are two of the areas that breastfed kids do better in—the reason may be the fatty acids found in breast milk.

6. Reduced postpartum depression. Moms who don’t breastfeed or stop early on have a greater risk of postpartum depression, according to a review by the National Institutes of Health. Those who nurse are more likely to have high levels of the feel-good hormone oxytocin, which promotes relaxation and keeps stress levels down.

The Physical Changes

As the weeks wear on, your body will continue to change to accommodate the baby, which could make for an uncomfortable few months while you wait for labor to arrive. As you gain weight, your breasts will keep growing and perhaps leak colostrum (the liquid produced before milk), your back may ache, you might get winded easily, and you’ll likely have to visit the restroom for bathroom breaks a lot more often than you did pre-pregnancy (things like sneezing and laughing could lead to some leakage—embarrassing, yes, but totally normal). The unlucky will have to deal with stretch marks on the abdomen; spider veins in the face, arms and neck; and varicose veins in the legs and rectum—also known as hemorrhoids when they pick this spot to strike.

You may start to have noticeable Braxton Hicks contractions as well. These “practice” contractions differ from the real deal in that they don’t get stronger or closer together as they go, but they may be uncomfortable.

The Emotional Changes

Playing the waiting game can be difficult, especially with all the physical discomfort that goes along with it. The reality that you’re about to be a parent for the first time (or again!) will hit you harder than it has before, and that can spark anxious thoughts. Talking about your fears with your partner or other moms (and even your baby) can be helpful, as can journaling. You can never totally prepare for what’s about to happen, but reading books, taking classes and getting everything ready can help ease your concerns and make you feel as ready as possible.

The Baby’s Changes

During the third trimester, your baby’s getting all the finishing touches, if you will—his eyes blink for the first time, his bones fully form, and the lanugo (fine, downy hair) on his body sheds. At this stage, babies gain weight rapidly, sprouting up from around 2.5 pounds at the beginning of the trimester to their delivery weight of 6 to 9 pounds or so. It’s even possible that your baby is having sweet dreams when he sleeps now—although it’s anyone’s guess as to what they’re about. Pretty soon, you’ll get to ask him yourself!

The Doctor’s Visits

From 28 to 34 weeks, your appointments will increase to every other week. We’ll monitor your weight gain, blood pressure and urine; listen to the fetal heartbeat; and check the baby’s position. You can also expect to be screened for gestational diabetes and Group B strep (bacteria that can cause an infection with your baby), and, as a part of our OB VIP program, we’ll review your birth plan, including cord blood banking and breastfeeding, to make sure you are ready and set to go. At 36 weeks, we’ll start to see you every week, and if you go past your due date, you’ll come in twice a week until the baby is born. Whatever questions you have, please ask! We are here for you and are committed to making sure that you have a great birth!

When it comes to what to be thankful for, nothing trumps your health. Money, love, success, personal goals—none of them are possible without good health to give them rise.

In this time of reflection and thanks, you might consider paying it forward by supporting a worthy cause that helps women who, perhaps, have not been as fortunate as you in health department.

Here are a five fantastic ones to consider:

Best for Babes

A revolutionary, paradigm-changing organization that’s helping women beat the Booby Traps (as they call oh so cleverly call them) that prevent moms from achieving their own personal breastfeeding goals, Best for Babes is giving breastfeeding a makeover. From women’s health to women’s rights, Best for Babes is on the forefront of freeing women from the shackles of misinformation and judgment that are so deeply ingrained in our popular consciousness and serve to disempower women at the most crucial time in their lives. This is feminism 2.0: Giving women back their power to take care of themselves and their babies, emotionally, physically and spiritually, and, by proxy, nurture future generations on all levels too. To support, go to www.BestforBabes.org.

Breast Cancer Research Foundation

89% of funding goes to programs that award research grants to experts seeking prevention methods and treatments. No big business here—just a steadfast determination to find a cure by investing in prevention. The BCRF’s funds have fostered some of the field’s biggest discoveries of late, including uncovering that women of African decent often have a genetically different form of breast cancer than woman of European ancestry. To support, go to www.BCRFCure.org.

National Ovarian Cancer Coalition

With growing nationwide chapters spearheaded by local volunteers that understand the needs of their communities, the NOCC provides support and encouragement in a real and immediate way. On the national level, the NOCC empowers women and the people who love them with the awareness they need to get educated about ovarian cancer with initiatives like T.E.A.L (Take Early Action and Live) and Break the Silence, in conjunction with Dr. Oz. To support, go to www.Ovarian.org.

Postpartum Support International

One in eight women suffer from postpartum depression—and most of those women do it in silence. Even the most otherwise empowered and together women buckle under the weight of this confounding disorder. PSI serves to give women essential information about perinatal mood and anxiety disorder, aka postpartum depression, including risk factors, symptoms and treatments, and connects them to the best local resources available so they get on the road to recovery. To support, go to www.Postpartum.net.

HealthyWomen

No, we didn’t just pick it because we like the name! This women’s health nonprofit is a one-stop shop for the latest scoop on everything from birth control to mental health to digestive disorders to cancer to sexual health. With a mission of educating, informing and empowering women to make the smartest health choices, HealthyWomen is a trusted go-to for objective, expert, evidence-based need-to-know-now info. To support, go to www.HealthyWomen.org.

Lately, we’ve been thinking about what makes us different from other groups? The answer: A whole lot. This realization sparked us to launch a new and groundbreaking program called OB VIP.

What is it and what can it mean for you?

OB VIP is an optional specialized program for our pregnant patients—and a big reason why our group is so different from the rest.

The program includes:

• Access to our prenatal coordinator Grace Kasnowski (also called our maternity concierge), who, along with our doctors and medical assistants, is here to help you every step of the way
• Full access to our website, which features blog posts ripe with need-to-know info, created just for you
• Daily social media support
• Weekly email support
• Access to our Pregnancy Connect program, which offers you entree to the best businesses, services and organizations for pregnant and new moms.
• Breastfeeding classes, in conjunction with BestforBabes.org, a celebrity and new mommy loved organization that is giving breastfeeding a makeover by removing the Booby Traps that stop women from achieving their own personal breastfeeding goals—whether those goals are for one day, one week or one year.
• Postpartum support
• And lots more!

The crowning jewel of program? A special 24-week prenatal visit to create your birth plan. All prenatal patients get a 24-week prenatal visit with myself or my husband to go through birth expectations and ensure that the experience can be just as she hopes it will be. Let’s face it: Having a baby is scary! There are also many options available to moms now. Whether you choose to get an epidural or go completely natural, it’s your choice—but making that decision—and many others involved in the birthing process—isn’t always so easy. We will talk to you about how you want your birth to be, give you the options and empower you with the information you need to make the best decisions for yourself.

We are here to support you—whatever your decisions.

We are your advocates.

And that means that we will be there for you on the big day too. You will always be delivered by one of our docs. This is a big deal. We have no laborists and many practices do. Almost every week in the office, I see a new pregnant patient who is changing doctors because she did not realize that someone she did not know (who was covering for her doctor) did her previous delivery.

So hopefully, if you are pregnant, you are already a Healthy Woman patient but if you are not, please make sure your questions are answered thoroughly and you feel supported by your practitioner.

We want you to get the VIP treatment during her most exciting, exhilarating and sometimes even exasperating time in her life. Why? Because you deserve it!

We’re here for you, so call us 732.431.1616.

“My husband and I were so thrilled with Healthy Woman’s prenatal class run by Jennifer Iannacone. We were pleasantly surprised that in the time we spent there, we were not only informed, but entertained. Jennifer’s work and personal experiences meld perfectly to educate us on the possibilities and technicalities of what it is to bring a child into this world. Jennifer was well prepared and very thorough with all of us “newbies.”

Jennifer was excellent because she was so prepared—and even more importantly to me, she did not have an agenda. She was open about her personal likes, dislikes and experiences but also offered a different angle for the many different minds seated before her. Her tricks of the trade, such as her tennis ball (to ease back pain during labor), were very creative and effective.

Having given birth I can say that her techniques, suggestions and information were effective. Overall, I would say that this class is not only a great experience, but one not to be missed. Jennifer’s prenatal class is number one!”

With the fall settling in and winter right on its heels, the flu shot is the definitely a hot topic.

Every season as the weather cools, our patients heat up with urgent questions about the flu shot: “Should I get the flu shot?”; “Is the flu shot safe in pregnancy?”; “I am breastfeeding – do I still need the flu shot?”

Here, I answer your questions and explain why the flu shot is for you, dear Healthy Woman patients.

Pregnancy puts extra stress on your heart and lungs. Pregnancy can also affect your immune system. Protection is paramount during pregnancy because your immune system is suppressed, which puts you at a higher risk of catching every bug that’s making the rounds — especially the influenza virus. These factors increase the risk of not only getting the flu but of developing serious complications of the flu, such as pneumonia and respiratory distress. If your due date falls within the flu season (October to April), your baby runs the risk of getting sick, too, both because the baby’s immune system is not yet fully developed and there’s no safe flu vaccination for babies under six months old. There is an increased risk of not only getting the flu but of developing serious complications such as pneumonia and respiratory distress. In turn, flu complications increase the risk of premature labor, preterm birth and other pregnancy complications. A flu shot can help prevent these potential problems.

What’s more, there is evidence that getting a flu shot during pregnancy offers your baby some protection after birth. He may receive some antibodies from you during pregnancy. And if you are immune, your newborn is less likely to be exposed to flu. (For this reason, make sure other family members get vaccinated too.) Protecting your infant is important because young babies who catch the flu are at particular risk for serious illness, but they can’t be vaccinated themselves until they’re 6 months old.

In the June issue of the American Journal of Obstetrics & Gynecology, a new study sponsored by the Centers for Disease Control and Prevention suggests that getting your flu shot during pregnancy can protect your newborn and reduce the likelihood that your baby will catch the infectious disease. Babies in the study were 48 percent less likely to be hospitalized for flu if their mothers were vaccinated during pregnancy versus those who were not vaccinated.

You’ll need a flu shot even if you’ve had one in previous years because different strains of flu come around every year. Get the flu shot as soon as it’s available regardless of which trimester you’re in. If your doctor or midwife doesn’t have a supply, call your local health department and find out if it’s available elsewhere in your community. The American Lung Association offers an online flu vaccine clinic locator. Visit www.flucliniclocator.org, enter a zip code and a date (or dates), and receive information about clinics scheduled in your area. Or try the CDC’s flu vaccine finder. Since pregnant women are at such high risk for serious flu-related complications, they’re given priority to receive the vaccine.

There is also a nasal flu vaccine called FluMist that contains live but weakened viruses. The nasal flu vaccine is not recommended during pregnancy because it has not been tested in pregnant women. The FluMist nasal vaccine can be used in healthy people aged 2-49 years old.

It’s best to get the flu shot in September or October so you’re protected before the flu season begins. But if you miss getting the shot in the fall, it’s still worth getting vaccinated later because the flu season can last into May. The flu shot available during the 2011-2012 flu season offers protection from both H1N1 flu (swine flu) and seasonal flu.

Some precautions prior to taking the shot:

If you’re allergic to eggs, check with your doctor before receiving a flu shot or if you’re sick and have a fever, wait until your symptoms are gone to get your flu shot. Some moms-to-be are concerned about the preservative Thimerosal, used in some flu shots. The CDC has found no convincing evidence of harm resulting from exposure to this preservative in vaccines, and both the CDC and ACOG say the benefits of the flu shot far outweigh the theoretical risk, if any, from Thimerosal.

To protect yourself and your growing family from the flu, the CDC is also urging people to follow its three-step approach to prevention:

1. First, get a flu shot.

2. Second, make sure to wash your hands and cover your mouth when you cough. Your family and any child caregivers should do the same.

3. If you do get the flu, visit your doctor and follow his or her orders on medication to help reduce the risk of complications. Some of the other simple measures are also listed.

4. Avoid crowds.

5. Avoid contact with people who have a cold.

6. Do not touch your eyes, nose, or mouth. Germs are often spread when you touch a contaminated surface and then touch your eyes, nose, or mouth.

Please contact your doctor if you come down with any of the flu symptoms or before trying any of the over the counter medications. However, some of the home remedies that you can try risk-free are listed below.

1. Use sugar, ginger or honey-based lozenges to relieve sore throats and cough.

2. Get plenty of bed rest.

3. Drink ample fluids, such as water, juice, and caffeine-free tea.

4. Put an air humidifier in your room to provide extra moisture, which can help reduce congestion

Many flu and cold medications have not been well studied in pregnancy, check labels carefully! Treatments for cold and flu symptoms during pregnancy include:

1. Acetaminophen

2. Saline nasal spray or nasal irrigation

3. Pseudoephedrine (decongestant and may be helpful for some people). Avoid pseudoephedrine in the first trimester, if you have hypertension or are hyperthyroid.

Since pregnant women with flu are at greater risk of serious illness and death from flu, the Centers for Disease Control and Prevention and the American College of Obstetrics and Gynecology recommend the use of Tamiflu (Oseltamivir) in pregnant women with suspected or test-proven flu.

Stay safe!

Cheers in health,

Neeti Misra MD FACOG

In honor of National Breastfeeding Month and World Breastfeeding Week, we asked Best for Babes, a nonprofit that’s giving breastfeeding a makeover by empowering women with the education, acceptance and support they need to achieve their own personal breastfeeding goals, for the breast, eh, uh, we mean best way we can help our sisters with babes in arms.

“We’ve got to beat what we call the Booby Traps that keep moms who want to breastfeed from achieving their personal breastfeeding goals. We cheer all moms on without pressure, judgment or guilt, whether they want to breastfeed for two weeks, two months, two years or not at all. According to the Centers for Disease Control and Prevention, 86 percent of expecting moms say they want to breastfeed, 74 percent try to breastfeed, and most are not able to breastfeed exclusively for three weeks, let alone the minimum six months recommended by the American Academy of Pediatrics—only 14 percent make it that far, and it’s not their fault! Women are being pressured to breastfeed but are set up to fail. Moms’ best intentions are being undermined by poor hospital practices, lack of maternity leave policies, social disapproval and a myriad of other Booby Traps. All this at a time when obesity, diabetes, heart disease, asthma, allergies and breast cancer rates are soaring; the risk for all these diseases is lowered by mostly or exclusively breastfeeding,” says Best for Babes Co-Founder Bettina Forbes. Forbes, a certified lactation consultant with a background in social entrepreneurship, launched the organization in 2007 with Danielle Rigg, a former lawyer and current certified lactation consultant.

So, if you’re ready to beat those Booby Traps, take control of your own personal breastfeeding goals and help your fellow moms do the same, now is the perfect time to speak up!

The theme of this year’s World Breastfeeding Week is communication and in celebration of its message, here are Forbes’ five ways you can do more than give it lip service.

1.  Give a nursing mom a thumbs up.  A lot of moms are nervous about breastfeeding in public, so a warm smile or  a quick “great job” as you pass by can do wonders for another mother’s confidence and self-esteem.

2.  Ask questions. Next time a friend or acquaintance tells you she is expecting, don’t launch into a thesis about breastfeeding’s benefits. Ask her “What have you heard about breastfeeding?” Only by listening FIRST can we be truly helpful and know better which information, if any, would best suit your friend . . . and you may save yourself from having egg on your face too.  We have heard of women who rattle off scientific facts of milk production to a double mastectomy survivor, when they should have been talking about donor milk and the universal gift of skin to skin.

3.  Share your own personal experience.  Better than facts? Telling women that you were nervous about breastfeeding, but that once you got through the learning curve, it was a great experience.  Or that you didn’t want to breastfeed, but were so glad that you did. Or that the best thing you did was take a really good breastfeeding class and interview an IBCLC.

4.  Thank your breastfeeding-supportive health professional.  Write a note to the night nurse who helped you latch and re-latch until it was comfortable, or the pediatrician who told you to see an IBCLC, and copy the hospital or the state chapter for the American Academy of Pediatrics.  One of the worst Booby Traps is a well-meaning but misinformed health professional . . .  all the more reason to recognize those that do it right!

5.  Tell off a judgmental busybody.  If there’s one thing we have zero tolerance for, it’s the naysayers and nosybodies that make other moms feel bad, whether they are breastfeeding  or bottle-feeding.  Whether they are telling a nursing mom to move to the bathroom (gross!) or telling a formula-feeding mom that she is poisoning her child (psycho!) let the ranter know that building a mother’s confidence is much more effective than tearing her down.  And say it sweetly, with a smile!

For more from Best for Babes, go to www.BestforBabes.org.

Registering for all that you’ll need when your bundle-of-joy finally arrives is a daunting task—to say the least. Will one stroller be sufficient? Is a bouncy chair really necessary? How many crib sets should I get? Oh, the list of questions goes on and on and on. We’re big fans of soliciting such advice (not to mentioned gently-used hand-me-downs) from family and friends, but if you find yourself sans reliable feedback, our guide to all the things you really need may be in order.

Without further ado, here’s our list of the top 12 baby registry must-haves:

1. An Infant Car Seat

There are lots of available options, at multiple price points, when it comes to infant car seats. A good rule of thumb to guide you in choosing the right one for you is to check the latest Consumer Reports ratings and select one from the top of the list. For the latest on car seat safety, from choosing the right one to installing it to trading up, check out Healthy Children’s 2011 piece on car safety seats.

2. A Stroller

Strollers, much like cars, vary in style, number of features, maneuverability and, of course, price. Because of these factors, in many ways the right stroller depends largely on your personal preferences and needs. If you’re a city family, you’ll need something that can handle being wheeled around city streets, and might not necessarily need to be put in the back of a car. If you’re a more suburban or rural family, you’ll likely want something easily foldable or one that can handle long walks or mall trips. Other factors to consider: If this is your second child, you might want to register for a stroller that will accommodate both an infant and a toddler; Expecting twins? There’s a large variety of strollers for multiples on the market; Are you the sporty type? Consider registering for a jogging stroller instead of—or in addition to—a regular one.

3. A Play Yard/Portable Crib

An essential for travel or an impromptu nap at a friend’s house, a portable crib is something you’ll definitely need. Many come with all sorts of bells and whistles, but it’s doubtful that you’ll really utilize them. Therefore, we advise selecting one that is lightweight but sturdy, and simple to assemble.

4. Baby Furniture

Much like a stroller, baby furniture is largely a matter of personal preference, taste, lifestyle and available space. From modern to classic to funky to fabulous, nursery furniture is aplenty so rest assured that you’ll find what you’re looking for. If you’ve got the space, consider getting a crib, a dresser/changing table combo unit, a glider and some sort of book/toy case. Be sure to go for the all-natural or organic brands when you can—for nursery furniture and just about anything and everything else on your baby registry.

5. Crib Linens

Crib linens, like all room décor, are largely a matter of personal taste. Most sites offering crib linens feature registry options. Our tip: register for two or three extra (organic cotton, naturally) crib sheet sets, as you’ll need to change them often.

6. A Bouncy Chair

A bouncy chair will come in very handy when you need to set your babe down or need a short break. He’ll sit upright in it, and ideally, it will keep him entertained and soothed—well, you know, long enough to return an email or brush your teeth.

7. Bathtime Essentials

Pretty soon after you bring her home, she’ll need her first bath. Make sure you register for all of the essentials: a tub, some organic cotton baby washcloths (they’re much gentler than regular ones) and organic baby bath products.

8. Bibs

You’ll need lots of these to start—more than you think! For newborns, stick to the fabric bibs—you won’t need plastic ones until baby begins eating solid foods.

9. Burp Cloths

Along the same lines as bibs, you’ll need a bunch of burp cloths (unless you plan on doing laundry all the time).

10. Onesies

Your baby will most likely go through a few each day so having extra is a good idea. Don’t rely on others to buy them for you; stock up on six or so before baby arrives. The ones that snap or zip up the front are the easiest to take off and put on.

11. Breastfeeding Essentials

A quality, comfortable breast pump that travels well, along with BPA-free bottles for storage, are definite must-haves. Other helpful breastfeeding gear include a breastfeeding pillow, several cute nursing tanks/tops, a few good (and sexy!) nursing bras, nipple cream and nursing pads.

12. A Diaper Bags

You’ll need a diaper bag to hold all sort of stuff: changing essentials, feeding essentials, a change of clothes, some toys and your personal items. Most diaper bags offer plenty of room for all of these essentials, so ultimately, your choice may come down to style and price. When it comes to style, choosing a diaper bag is much like picking a purse—and there are nearly as many varieties.

Fortunately, breastfeeding 2.0 is a much more personal, empowered and approachable pursuit (aka devoid of the judgment, confusion and misinformation of generations’ past).

So how exactly can breastfeeding be beneficial? Let us count the ways:

1. Illness prevention. The nutrients in a mother’s breast milk are designed exclusively for her baby—and that’s something formula just can’t reproduce. Babies who are breastfed are less likely to suffer from ear infections, stomach viruses, meningitis, respiratory problems and other illnesses, and when they do get sick, they tend to kick it faster. This is largely thanks to a substance in breast milk known as immunoglobulin A, which creates a layer over the mucous membranes of the nose, throat and intestinal tract, helping protect them from harm.

Children continue to benefit from a bolstered immune system later in life, even after breastfeeding has ceased. They’re at a lower risk for some childhood cancers, diabetes and high cholesterol, among other diseases.

2. Cost savings. Formula isn’t cheap. And while you may purchase a breast pump and other accessories—like nursing tops and pillows—to aid you, it’s likely to come out to be less in the long run than the price of formula and bottles. Don’t forget the potential savings when it comes to health care costs, too.

3. Allergy protection. Formula-fed babies have more allergic reactions. Scientists think that the same protective layer provided by breast milk that helps guard against diseases also steels the body against allergic reactions. With the protective coating of immunoglobulin A around the inside of the intestines, allergens are less likely to penetrate through. By getting only breast milk, babies also aren’t exposed to the allergens that can come with cow’s milk or soy milk.

4. Bonding. Many moms find nursing to be one of the best ways to bond with their babies. Mothers who nurse on average hold, speak to and rock their babies more often (even when not feeding). The skin-to-skin contact helps form a strong connection, and research has shown that hormones released while breastfeeding increase a woman’s feelings of love and affection.

5. Increased intelligence. Although the question of whether breastfeeding boosts brainpower is a hotly debated one, it certainly can’t hurt. Studies have found that vocabulary and cognitive development are two of the areas that breastfed kids do better in—the reason may be the fatty acids found in breast milk.

6. Reduced postpartum depression. Moms who don’t breastfeed or stop early on have a greater risk of postpartum depression, according to a review by the National Institutes of Health. Those who nurse are more likely to have high levels of the feel-good hormone oxytocin, which promotes relaxation and keeps stress levels down.

Whether it’s for six days, six weeks, six months, one year or longer, your experience with breastfeeding should be a positive one. Learn more about how to beat the booby traps from Best for Babes, a nonprofit giving breastfeeding a makeover and empowering moms to achieve their own personal breastfeeding goals.