This is a diet based on eating foods that maintain an optimal pH level within our body fluids, including blood and urine. The foods we eat can be classified as either acid-forming or alkaline-forming.Consumption of high quantities of acid-forming foods disrupts the normal pH levels, creating an imbalance which increases susceptibility to illness. The idea behind the diet is that disease cannot thrive in a body that has an optimum pH, which is slightly alkaline. #### **What can I eat on the Alkaline diet?** Foods are classified as either alkaline, neutral or acid: * Alkaline foods: Vegetables, fruits, nuts, legumes * Neutral: Starches, sugars, natural fats * Acidic foods: Meat, poultry, fish, dairy, eggs, grains, alcohol People on the alkaline diet should aim to eat as many alkaline foods as possible. #### **What can’t I eat on the Alkaline diet?** * Dairy * Eggs * Canned and packaged snacks * Alcohol * Caffeine #### **What are some of the proposed benefits to the alkaline diet?** * Helps to prevent heart disease, due to lower fat intake. * Rapidly promotes weight loss. * A lower acid diet can ease symptoms of kidney damage. * Alkaline minerals in the diet help to reduce back pains. * The diet promotes healthy muscles. #### **Are there any negatives to the Alkaline diet?** * The diet is based on limited research and it is unlikely that a diet can have a considerable effect on our blood PH. * Our bodies are equipped to balance it’s internal systems and many foods that are avoided in this diet are actually healthy foods such as eggs and whole grains For further information on modern diets, click [here](https://nabtahealth.com/5-modern-diets-dissected/). Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#423b232e2e23022c232036232a27232e362a6c212d2f) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * Blackburn, K. “The Alkaline Diet: What You Need to Know.” _MD Anderson Cancer Center_, Sept. 2018, [www.mdanderson.org/publications/focused-on-health/the-alkaline-diet–what-you-need-to-know.h18-1592202.html](http://www.mdanderson.org/publications/focused-on-health/the-alkaline-diet--what-you-need-to-know.h18-1592202.html). * Cohen, J. “The Trendiest Diets Of 2018: Will They Work For You?” _Forbes_, 1 June 2018, [www.forbes.com/sites/jennifercohen/2018/06/01/the-trendiest-diets-of-2018-will-they-work-for-you/#55a137aa3aca](http://www.forbes.com/sites/jennifercohen/2018/06/01/the-trendiest-diets-of-2018-will-they-work-for-you/#55a137aa3aca). * Leech, Joe. “The Alkaline Diet.” _Healthline_, Healthline Media, 25 Sept. 2019, [www.healthline.com/nutrition/the-alkaline-diet-myth](http://www.healthline.com/nutrition/the-alkaline-diet-myth). * Schwalfenberg, G K. “The Alkaline Diet: Is There Evidence That an Alkaline PH Diet Benefits Health?” _Journal of Environmental and Public Health_, vol. 2012:727630, 2012, doi:10.1155/2012/727630. * Vormann, J, et al. “Supplementation with Alkaline Minerals Reduces Symptoms in Patients with Chronic Low Back Pain.” _Journal of Trace Elements in Medicine and Biology_, vol. 15, no. 2-3, 2001, pp. 179–183., doi:10.1016/S0946-672X(01)80064-X.
Popularly known as the ‘Keto’ diet, this is a low-carbohydrate, moderate-protein and high-fat diet that helps burn fat more easily. Our bodies run on either glucose or fat. A low carbohydrate intake sends the body into a metabolic state known as ketosis. This is where the liver produces ketones from fat. These ketones serve as a fuel source throughout the body. This means the fat from your body and from your diet is what is used as energy, hence this is the theory behind the weight loss seen with this diet. #### **What can I eat on the keto diet?** * Non-starchy vegetables, such as beans, broccoli, spinach and carrots. * Seafood * Plain Greek yoghurt * Meat and poultry * Coconut oil * Olive oil * Nuts and seeds * Berries * Butter and cream * Dark chocolate and cocoa powder #### **What can’t I eat on the keto diet?** * Cereal * Beer * Sweetened Yoghurt * Starchy vegetables (corn and sweet potato) * Low fat salad dressing * Beans and legumes * Gluten-free baked goods #### **What are some of the proposed benefits to the keto diet?** * Helps in improving [](https://nabtahealth.com/what-is-pcos/)[PCOS](https://nabtahealth.com/glossary/pcos/) symptoms. * Protects brain function. * Helps with excess weight loss. * Helps in reducing acne. * Helps reduce risk of all cancer types. * Helps in reducing seizures, especially for people diagnosed with epilepsy. * Contains neuroprotective benefits that protect and strengthen brain functions. #### **Are there any negatives to the keto diet?** * Some people tend to experience ‘Keto Flu’ that results in fatigue, gastrointestinal distress and lethargy. It tends to pass away after sometime. * [Diarrhoea](https://nabtahealth.com/glossary/diarrhoea/). This can occur as a result of lack of fibre in the diet and is common with low carb intake. * The risk of heart disease is a concern with such high fat diets. * Other problems associated with this diet are nutrient deficiency, [constipation](https://nabtahealth.com/glossary/constipation/), increased stress on the liver and kidneys and increased irritability. For further information on modern diets, click [here](https://nabtahealth.com/5-modern-diets-dissected/). Also try Nabta’s [Energy booster](https://nabtahealth.com/product/energy-multivitamin-daily-booster/). Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#87fee6ebebe6c7e9e6e5f3e6efe2e6ebf3efa9e4e8ea) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * Cohen, J. “The Trendiest Diets Of 2018: Will They Work For You?” Forbes, 1 June 2018, [www.forbes.com/sites/jennifercohen/2018/06/01/the-trendiest-diets-of-2018-will-they-work-for-you/#55a137aa3aca](https://www.forbes.com/sites/jennifercohen/2018/06/01/the-trendiest-diets-of-2018-will-they-work-for-you/#55a137aa3aca). * Gibas, Madeline K., and Kelly J. Gibas. “Induced and Controlled Dietary Ketosis as a Regulator of Obesity and Metabolic Syndrome Pathologies.” Diabetes & Metabolic Syndrome: Clinical Research & Reviews, vol. 11, Nov. 2017, pp. S385–S390., doi:10.1016/j.dsx.2017.03.022. * Gower, B A, and A M Goss. “A Lower-Carbohydrate, Higher-Fat Diet Reduces Abdominal and Intermuscular Fat and Increases Insulin Sensitivity in Adults at Risk of Type 2 Diabetes.” Journal of Nutrition, vol. 145, no. 1, Jan. 2015, pp. 177S–183S., doi:10.3945/jn.114.195065. * “Should You Try the Keto Diet?” Harvard Medical School, Oct. 2018, [www.health.harvard.edu/staying-healthy/should-you-try-the-keto-diet](http://www.health.harvard.edu/staying-healthy/should-you-try-the-keto-diet).
Children need sleep. As any parent will tell you, dealing with a grumpy, sleep-deprived infant is no fun. The amount of sleep a child requires changes as they grow older, as demonstrated by these guidelines from the National Sleep Foundation. \[table id=11 /\] Despite these guidelines, it is important to remember that every child is different, so there can be some variation in the number of hours they sleep. #### **Why is sleep so important?** Sleep is the brain’s primary activity in early development. It promotes mental and physical growth. Childhood is a time of very rapid growth and development and without sufficient sleep, children can struggle with maintaining attention and concentration throughout the day. Sleep and body weight are intricately linked across various age groups; shorter sleep duration is associated with a greater risk of obesity and a higher [](https://nabtahealth.com/what-is-body-mass-index-bmi/)[BMI](https://nabtahealth.com/glossary/bmi/). Furthermore, there is even the suggestion that children who do not get enough sleep, might be more likely to develop type 2 diabetes, which has significant health implications later in life. #### **What to do if you are worried** Establishing a consistent bedtime routine is key. It can be helpful to work backwards to calculate what an age appropriate bedtime is, particularly if your child needs to wake up for a certain time each day. The Sleep Advisor website provides a very useful chart you can use to do exactly this. It can be accessed [here](https://www.sleepadvisor.org/how-much-sleep-do-kids-need/). Sleeping too little or too much can be a sign of an underlying medical problem. If your baby or child is sleeping more than the recommended amount, but is still always tired, they may be suffering from a sleep disorder such as [sleep apnea](https://nabtahealth.com/sleep-apnea-in-kids-recognizing-the-symptoms/), which causes irregular breathing and can prevent them from entering into deep sleep cycles. It is also possible for young children to experience [](https://nabtahealth.com/i-cant-sleep-what-causes-insomnia-and-how-can-you-improve-your-sleep-quality/)[insomnia](https://nabtahealth.com/glossary/insomnia/), which is a condition probably more usually associated with adults. Minimising screen time before bed and adopting a calming routine can help, as can [supplements](https://nabtahealth.com/which-dietary-supplements-help-to-combat-insomnia/), but you should always consult a doctor first. For more information on the importance of childhood sleep routines visit the [Sleep Advisor website](https://www.sleepadvisor.org/how-much-sleep-do-kids-need/). **Sources:** * “How Many Hours of Sleep Do Kids Need?” _Sleep Advisor_, 21 Jan. 2021, [www.sleepadvisor.org/how-much-sleep-do-kids-need/](http://www.sleepadvisor.org/how-much-sleep-do-kids-need/). * Ophoff, D., et al. “Sleep Disorders during Childhood: a Practical Review.” _European Journal of Pediatrics_, vol. 177, no. 5, May 2018, pp. 641–648., doi:10.1007/s00431-018-3116-z. * Rudnicka, Alicja R., et al. “Sleep Duration and Risk of Type 2 Diabetes.” _Pediatrics_, vol. 140, no. 3, Sept. 2017, doi:10.1542/peds.2017-0338. * Xiu, Lijuan, et al. “Sleep and Adiposity in Children From 2 to 6 Years of Age.” _Pediatrics_, vol. 145, no. 3, Mar. 2020, doi:10.1542/peds.2019-1420. Powered by Bundoo®
Birth control is a way for a couple to prevent pregnancy. There are different types of birth control, including the Intrauterine Device ([IUD](https://nabtahealth.com/glossary/iud/)), implant, shot, patch, ring, and the [oral contraceptive pill](https://nabtahealth.com/the-oral-contraceptive-pill/) (the pill). The type of birth control you decide to use is a personal decision and will often be based on a doctor’s recommendation. Hormonal contraceptives include the pill, the patch, and the vaginal ring. They all contain synthetic (man-made) versions of the hormones [progesterone](https://nabtahealth.com/glossary/progesterone/) (called progestin) and [oestrogen](https://nabtahealth.com/glossary/oestrogen/). Hormonal contraceptives usually work by changing the cervical mucus, making it harder for the [](https://nabtahealth.com/everything-you-need-to-know-about-sperm/)[sperm](https://nabtahealth.com/glossary/sperm/) to swim or find the egg. They also prevent the body from ovulating. They are several types of hormonal contraceptives or hormonal birth control, and they include: #### **Oral Contraceptives** Oral contraceptives, also known as birth control pills are medications taken by mouth to prevent pregnancy. They are widely used, but before use, you should explore what side effects they cause, as well as how well they work. That way you will discover if they are also the best option for you. They are two types of oral contraceptives: 1. Combined pills 2. Mini pills ##### **Combined pills** Combined pills contain the hormones [oestrogen](https://nabtahealth.com/glossary/oestrogen/) and progestin. Taken throughout the cycle, most of the month you will take an active pill, meaning it contains hormones. Inactive pills (hormone free, or placebo) pills will be taken at certain times, depending on the exact pill you are on. There are different types of combined pills: * **Multiphasic pills**: These are taken for a one-month cycle, they provide varying levels of hormones throughout the cycle. During the last week of your cycle, an inactive (placebo) pill is taken, which causes a withdrawal bleed. * **Monophasic pills**: Mostly used in one-month cycles. However, each of these active pills offers you an equivalent dose of the hormone. Just like multiphasic pills, in the last week of your cycle an inactive placebo pill is taken, causing a withdrawal bleed. * **Extended-cycle pills**: These work differently from the multiphasic and monophasic pills. They are used for a 13-week cycle. The active pills are taken for 12 weeks, while the inactive pills are taken during the last week of your cycle. This results in you having withdrawal bleeding only three to four times per annum. ##### **Mini pills** Mini pills are birth control pills that only contain the hormone progestin. Therefore, they are known as progestin-only pills. There are no inactive pills and they are taken continually throughout the cycle, meaning you may or may not menstruate whilst using them. These pills are a good choice for women who cannot take [oestrogen](https://nabtahealth.com/glossary/oestrogen/) or have a history of blood clots in the lungs or in the legs. Mini pills usually solidify the cervical mucus and weaken the lining of the [uterus](https://nabtahealth.com/glossary/uterus/) (the endometrium), thus preventing [sperm](https://nabtahealth.com/glossary/sperm/) from reaching the egg. The pills also suppress [ovulation](https://nabtahealth.com/glossary/ovulation/); however, this is not constant, and can sometimes vary month to month. For optimal efficiency, you should take the mini pill every day at about the same time. Your doctor might recommend the mini pill if: * You have health problems, such as blood clots. * You are breast-feeding, as [oestrogen](https://nabtahealth.com/glossary/oestrogen/) can inhibit the production of breast milk. These pills are not appropriate for everyone. You should avoid, or seek medical advice, if: * You have ever had or have breast cancer. * In case of liver disease. * You have [unexplained uterine bleeding](https://nabtahealth.com/what-is-abnormal-uterine-bleeding/). * You are on medications for [HIV](https://nabtahealth.com/glossary/hiv/)/AIDS, seizures, or tuberculosis. As with all forms of birth control, there are several benefits and disadvantages that come with the use of birth control pills (oral contraceptives): ##### **Benefits** * Birth control pills can be used to treat painful periods. * They manage [unwanted symptoms](https://nabtahealth.com/menopause-the-symptoms-nobody-talks-about/) of [perimenopause](https://nabtahealth.com/glossary/perimenopause/); such as irregular periods, and even [hot flushes](https://nabtahealth.com/glossary/hot-flushes/). * They can help to reduce negative side effects of [](https://nabtahealth.com/coping-with-pms/)[premenstrual syndrome](https://nabtahealth.com/glossary/premenstrual-syndrome/) like cramps and mood swings. * Can be used to [avoid the need for](https://nabtahealth.com/will-i-need-to-have-my-uterus-removed-if-i-have-endometriosis/) [hysterectomy](https://nabtahealth.com/glossary/hysterectomy/) in those with debilitating [endometriosis](https://nabtahealth.com/glossary/endometriosis/). * When used for at least 5 years the pill [protects against the risk](https://nabtahealth.com/can-the-oral-contraceptive-pill-protect-against-cancer/) of endometrial cancer by 50% and also ovarian cancer by 20%. ##### **Disadvantages** * For some women, these birth control pills can [lead](https://nabtahealth.com/glossary/lead/) to an increase in blood pressure, increasing the risk of type 2 diabetes and heart disease. * The extra hormones can [lead](https://nabtahealth.com/glossary/lead/) to an increased risk of blood clots, especially for smokers. * Can [lead](https://nabtahealth.com/glossary/lead/) to weight gain. * Increased risk of certain types of cancer, including [cervical](https://nabtahealth.com/the-pill-and-cervical-cancer/), liver, and [breast cancer](https://nabtahealth.com/the-pill-and-breast-cancer/) has been connected to pill use. * When one stops taking the pills, the menstrual cycle can take months, and even years, to return to normal. #### **Mirena coil** The Mirena coil is classified as a hormonal [IUD](https://nabtahealth.com/glossary/iud/) that can offer long-term birth control, for up to 5 years after being inserted. It can be used by all premenopausal women, including teenagers. It is a T-shaped plastic frame, which is inserted into the [uterus](https://nabtahealth.com/glossary/uterus/). It releases the hormone progestin, preventing pregnancy as it stops [ovulation](https://nabtahealth.com/glossary/ovulation/). It has been approved for use by the Food and Drug Administration ([FDA](https://nabtahealth.com/glossary/fda-2/)). As well as being used as a contraceptive, the Mirena is prescribed to women with: * [](https://nabtahealth.com/what-is-endometriosis/)[Endometriosis](https://nabtahealth.com/glossary/endometriosis/). * [Heavy menstrual bleeding](https://nabtahealth.com/what-is-abnormal-uterine-bleeding/). * Abnormal growth of the [uterus](https://nabtahealth.com/glossary/uterus/) lining ([endometrial hyperplasia](https://nabtahealth.com/what-is-atypical-endometrial-hyperplasia/)). * Abnormal growth of the uterine tissue on the muscular wall of the [uterus](https://nabtahealth.com/glossary/uterus/) ([](https://nabtahealth.com/what-is-adenomyosis/)[adenomyosis](https://nabtahealth.com/glossary/adenomyosis/)). * [](https://nabtahealth.com/a-simple-guide-to-fibroids/)[Fibroids](https://nabtahealth.com/glossary/fibroids/). There are several benefits and disadvantages to using the Mirena: ##### **Benefits** * You do not require your partner’s participation. * It can remain in place when inserted for up to five years. * You can remove it at any time and theoretically experience a quick return to your normal fertility. * You can breast-feed while using it. * No risk of complications, such as [endometriosis](https://nabtahealth.com/glossary/endometriosis/), pelvic infection and severe period pain. These can all be triggered by birth control methods that contain [oestrogen](https://nabtahealth.com/glossary/oestrogen/). As such, the coil is often recommended for women with [endometriosis](https://nabtahealth.com/glossary/endometriosis/), and [fibroids](https://nabtahealth.com/glossary/fibroids/). ##### **Disadvantages** * Possible association with [cervical](https://nabtahealth.com/cervical-cancer-symptoms/) and [endometrial cancer](https://nabtahealth.com/a-guide-to-endometrial-cancer/). * Irregular [menses](https://nabtahealth.com/glossary/menses/), which can improve after 3-6 months of use. * It does not protect you from STIs. * You might have irregular bleeding. * Acne. * Headaches. * Breast tenderness. * Mood changes. If you conceive whilst the Mirena is in place, then the fertilised egg might be implanted outside the [uterus](https://nabtahealth.com/glossary/uterus/), generally in a fallopian tube. This is known as an [](https://nabtahealth.com/what-is-an-ectopic-pregnancy/)[ectopic pregnancy](https://nabtahealth.com/glossary/ectopic-pregnancy/) and can be very dangerous. #### **Vaginal Ring** Just like other hormonal birth controls, the vaginal ring prevents pregnancy through the release of hormones into the body. One can use the vaginal ring for 3 weeks, remove it and allow menstruation to occur, then after a week insert a new ring. There are two vaginal rings with [FDA](https://nabtahealth.com/glossary/fda-2/) approval in the United States: NuvaRing and Annovera. ##### **Benefits** * Easy to use and comfortable. * Can be removed at any time and fertility should be restored quickly. * Good for women experiencing latex (condom) allergies. * No weight gain. * Not likely to trigger irregular bleeding, unlike oral contraceptives. ##### **Disadvantages** * Can cause Vaginal irritation or infection. * Increased vaginal discharge. * Not recommended for women who have a history of blood clots, heart attacks, stoke and those over 35 years of age. * [Diarrhoea](https://nabtahealth.com/glossary/diarrhoea/). * Headache. * Breast tenderness. * Nausea. * Abdominal pain. * Depression Understanding your options as an individual and taking an open evaluation of the relationship you are in is certainly part of your choice process. It will help you in deciding which, if any, type of hormonal birth control is most suitable for you. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#b4cdd5d8d8d5f4dad5d6c0d5dcd1d5d8c0dc9ad7dbd9) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources** * Cooper DB, Mahdy H. Oral Contraceptive Pills. \[Updated 2020 Aug 23\]. In: StatPearls \[Internet\]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: [https://www.ncbi.nlm.nih.gov/books/NBK430882/](https://www.ncbi.nlm.nih.gov/books/NBK430882/) * “Hormonal [IUD](https://nabtahealth.com/glossary/iud/) (Mirena).” _Mayo Clinic_, Mayo Foundation for Medical Education and Research, 26 Feb. 2020, [www.mayoclinic.org/tests-procedures/mirena/about/pac-20391354](http://www.mayoclinic.org/tests-procedures/mirena/about/pac-20391354). * “Minipill (Progestin-Only Birth Control Pill).” _Mayo Clinic_, Mayo Foundation for Medical Education and Research, 29 Dec. 2020, [www.mayoclinic.org/tests-procedures/minipill/about/pac-20388306](http://www.mayoclinic.org/tests-procedures/minipill/about/pac-20388306). * “Vaginal Ring.” _Mayo Clinic_, Mayo Foundation for Medical Education and Research, 12 Feb. 2020, [www.mayoclinic.org/tests-procedures/nuvaring/about/pac-20394784](http://www.mayoclinic.org/tests-procedures/nuvaring/about/pac-20394784). * “What Should I Do If I Miss a Pill (Combined Pill)?” _NHS Choices_, NHS, [www.nhs.uk/conditions/contraception/miss-combined-pill/](http://www.nhs.uk/conditions/contraception/miss-combined-pill/).
* Taking the pill can mask the symptoms of [PCOS](https://nabtahealth.com/glossary/pcos/), not cure them. * The pill is designed to prevent pregnancy. * The pill does not regulate the menstrual cycle as regular [ovulation](https://nabtahealth.com/glossary/ovulation/) does not occur. * For women suffering discomfort with [PCOS](https://nabtahealth.com/glossary/pcos/), the pill can help alleviate some symptoms but other options for treatment should be considered alongside it. Following a [diagnosis of](https://nabtahealth.com/problems-with-traditional-diagnosis-of-pcos/) [PCOS](https://nabtahealth.com/glossary/pcos/), many women will be prescribed the combined [oral contraceptive pill](https://nabtahealth.com/the-oral-contraceptive-pill/) (‘the pill’). In theory, this sounds like a good idea; if [PCOS](https://nabtahealth.com/glossary/pcos/) is considered to be an endocrine system disorder, then regulating hormone levels should ease the symptoms. #### **What is the pill and why use it for [PCOS](https://nabtahealth.com/glossary/pcos/)?** The combined pill contains synthetic hormones: an [oestrogen](https://nabtahealth.com/glossary/oestrogen/) component that is anti-androgenic in nature and a [progesterone](https://nabtahealth.com/glossary/progesterone/) component, which suppresses secretion of luteinising hormone. In combination this reduces some of the signs of [hyperandrogenism](https://nabtahealth.com/glossary/hyperandrogenism/), for example, acne and [](https://nabtahealth.com/how-to-manage-facial-hair/)[hirsutism](https://nabtahealth.com/glossary/hirsutism/), and, seemingly, regulates the menstrual cycle. #### **When should the pill not be prescribed for [PCOS](https://nabtahealth.com/glossary/pcos/)?** [PCOS](https://nabtahealth.com/glossary/pcos/) is one of the predominant [causes of female](https://nabtahealth.com/causes-of-female-infertility-failure-to-ovulate/) [infertility](https://nabtahealth.com/glossary/infertility/), thought to be responsible for up to 70% of cases. For those women experiencing [PCOS](https://nabtahealth.com/glossary/pcos/)\-induced [infertility](https://nabtahealth.com/glossary/infertility/), the pill is not an answer. By very definition, its main function is to prevent pregnancy. In addition to this, metabolic conditions, which are a common comorbidity alongside [PCOS](https://nabtahealth.com/glossary/pcos/), can be exacerbated, or triggered by some versions of the combined oral contraceptive pill. It is claimed that the pill helps to regulate the menstrual cycle, but this is not true. The monthly bleeds experienced by women taking the pill are withdrawal bleeds, not normal menstruation, so regular, cyclical [ovulation](https://nabtahealth.com/glossary/ovulation/) is still not occurring. This can [lead](https://nabtahealth.com/glossary/lead/) to disappointment for those women who have been taking the pill with the hope of regulating their cycles, so that upon withdrawal they can become pregnant. If they had irregular cycles before going on the pill, they are highly likely to revert back to a similar state once they stop taking it and find it equally difficult to conceive. Furthermore, many specialists believe that current, or previous, use of the oral contraceptive pill, can even [give rise to](https://nabtahealth.com/factors-that-contribute-to-transient-pcos-like-symptoms/) [PCOS](https://nabtahealth.com/glossary/pcos/)\-like symptoms, which can cause women who have never had [PCOS](https://nabtahealth.com/glossary/pcos/) before to start experiencing some of the common complaints of the condition, including [infertility](https://nabtahealth.com/glossary/infertility/). This is usually a transient condition, but can further hinder attempts to conceive. #### **Is there ever a time when the pill can help?** Taking all of this into account, it would be amiss to say that the pill is completely redundant in the treatment of [PCOS](https://nabtahealth.com/glossary/pcos/). It does bring symptomatic relief to a lot of women, particularly those with heavily hyperandrogenic [PCOS](https://nabtahealth.com/glossary/pcos/). As a means of birth control, it is one of the most widely used options available. It also appears to reduce the risk of developing [endometrial cancer](https://nabtahealth.com/can-the-oral-contraceptive-pill-protect-against-cancer/). Women with [PCOS](https://nabtahealth.com/glossary/pcos/) are up to three times more likely to be diagnosed with endometrial cancer, due to unopposed exposure of the [uterus](https://nabtahealth.com/glossary/uterus/) to [oestrogen](https://nabtahealth.com/glossary/oestrogen/). Taking the pill could significantly reduce this risk. Thus, the pill should not be disregarded as an option for treating [PCOS](https://nabtahealth.com/glossary/pcos/), but doctors should be prepared to explore other options alongside, or in place of it, rather than seeing it as the treatment of choice for all patients. To learn more about [PCOS](https://nabtahealth.com/glossary/pcos/) click [here](https://nabtahealth.com/five-things-your-doctor-probably-wont-tell-you-about-pcos/). Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#f58c94999994b59b949781949d909499819ddb969a98) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * Azziz, R, et al. “Positions Statement: Criteria for Defining Polycystic Ovary Syndrome as a Predominantly Hyperandrogenic Syndrome: an Androgen Excess Society Guideline.” _The Journal of Clinical Endocrinology and [Metabolism](https://nabtahealth.com/glossary/metabolism/)_, vol. 91, no. 11, Nov. 2006, pp. 4237–4245., doi:10.1210/jc.2006-0178. [https://pubmed.ncbi.nlm.nih.gov/16940456/](https://pubmed.ncbi.nlm.nih.gov/16940456/) * De Melo, A S, et al. “Hormonal Contraception in Women with Polycystic Ovary Syndrome: Choices, Challenges, and Noncontraceptive Benefits.” _Open Access Journal of Contraception_, vol. 8, 2 Feb. 2017, pp. 13–23., doi:10.2147/OAJC.S85543. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774551/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774551/) * El Hayak, S, et al. “Poly Cystic Ovarian Syndrome: An Updated Overview.” _Frontiers in Physiology_, vol. 7, 5 Apr. 2016, p. 124., doi:10.3389/fphys.2016.00124. [https://www.frontiersin.org/articles/10.3389/fphys.2016.00124/full](https://www.frontiersin.org/articles/10.3389/fphys.2016.00124/full) * Rotterdam ESHRE/ASRM-Sponsored [PCOS](https://nabtahealth.com/glossary/pcos/) Consensus Workshop Group. “Revised 2003 Consensus on Diagnostic Criteria and Long-Term Health Risks Related to Polycystic Ovary Syndrome.” _Fertility and Sterility_, vol. 81, no. 1, Jan. 2004, pp. 19–25. [https://pubmed.ncbi.nlm.nih.gov/14711538/](https://pubmed.ncbi.nlm.nih.gov/14711538/)
**1\. Low milk supply** ----------------------- Some women find themselves unable to produce an adequate [breast milk supply](https://nabtahealth.com/articles/low-milk-supply-we-can-help/) to meet their babies’ needs, but fortunately, there are some evidence-based options to help them increase their production. It’s important to note, however, that truly low milk supply is actually pretty rare among breastfeeding women, so before you try every tip on our list, be sure that it is really an issue for you. **2\. Focus on nursing** ------------------------ A great place to start trying to increase your milk supply is by setting aside a weekend (or a time when you have a partner or friend around to help) to take a “[nursing vacation](https://www.leadinglady.com/blogs/our-moms/what-is-a-nursing-vacation).” This means that instead of focusing on your to-do list, you focus entirely on your baby. Get as much skin-to-skin time as you can, and let your baby feed as much as he or she wants. This contact can not only increase your supply, it also gives moms much-needed rest and bonding time with baby. **3\. Feed more frequently** ---------------------------- The more you feed your baby (and empty your breasts), the more milk your body will produce. If your milk supply is low, you should consider letting go of plans to get your baby on a schedule or reduce nighttime feedings, in favor of [feeding your baby](https://nabtahealth.com/articles/3-rules-for-feeding-your-baby-solids/) whenever he or she is hungry. By doing so, your body should react by producing more milk. **4\. Pump** ------------ Again, removing more milk from your breasts is the goal here. Pumping or hand expression may be a good way to encourage breast milk production, but it’s also important to know what you need to do with the milk you are removing in this case. You should check with your [](https://nabtahealth.com/articles/when-should-you-see-a-lactation-consultant/)[lactation](https://nabtahealth.com/glossary/lactation/) consultant to see if your baby needs the pumped milk on a regular basis as a supplement (if there are any issues, like weight gain) or if it’s okay to store the milk for later use. While supplementing your baby’s diet is recommended in some cases, it’s important not to do so if it isn’t necessary because it can decrease your baby’s interest in nursing (because he or she may feel full from the supplement instead). **5\. Massage before feeding** ------------------------------ Unlike hand expression or pumping, massaging your breasts before feedings isn’t intended to remove any milk at that time. Instead, a pre-feed massage can increase the amount of [milk your baby](https://nabtahealth.com/articles/3-ways-to-boost-milk-supply/) is able to remove during a feeding. Again, if your baby takes in more milk, your body will likely try to keep pace by producing more. One massage method worth trying is the “massage-stroke-shake” approach. **6\. Herbal remedies** ----------------------- Herbs and medications, also called galactagogues, may also help you increase your milk supply. There isn’t much data to support whether or not these supplements work well, but that’s likely because there aren’t many good studies about them. If you choose to go this route, it’s important to be careful which ones you choose because all options are not of the same quality and some may have side effects. You should talk to your doctor or [](https://nabtahealth.com/product/at-home-lactation-consultation/)[lactation](https://nabtahealth.com/glossary/lactation/) consultant to help you decide. **7\. The bare necessities** ---------------------------- Cut back on pacifiers, bottles, and supplements that your baby can suck on and that replace the breast. These can all be distractions that can interfere with your milk supply. If you’ve been supplementing your baby’s diet with something like formula, be sure to [consult a pediatrician](https://nabtahealth.com/articles/when-should-your-pediatrician-send-your-child-to-an-ent/) to see if your baby really needs it. **8\. Relax!** -------------- It’s difficult to let go of stress and to focus on taking care of yourself when there is so much to do and think about. However, stress can keep your milk from letting down normally, so it’s important to try to relax. Even if your biggest stressor is the very fact that you have low milk supply, it’s important to remind yourself that any milk you produce is better than no milk at all. Take some time for yourself so that you can be your best self for your baby. **9\. Get checked out** ----------------------- As you navigate low milk supply, you may find that nothing is working to increase your _breast milk production_. If that’s the case, and you haven’t already discussed these issues with your doctor, it may be time to see if there are any underlying medical conditions. Conditions like undiagnosed [thyroid](https://nabtahealth.com/articles/how-thyroid-disease-can-affect-your-pregnancy/) disorders, [diabetes](https://nabtahealth.com/product/diabetes-nutrition-session/), and [polycystic ovarian syndrome](https://nabtahealth.com/articles/does-polycystic-ovary-syndrome-cause-infertility/) can all cause low milk supply. **10\. Cut out hormonal meds** ------------------------------ Did your milk supply start getting low after you started taking birth control again? Certain types of birth control can interfere with your milk supply, so if this is true for you, consider choosing another birth control method and cutting out hormonal medications. **Sources:** * Riordan and K * Wambach. Breastfeeding and Human [Lactation](https://nabtahealth.com/glossary/lactation/), 4th edition. Powered by Bundoo®
Any parent would worry if they saw signs of [puberty](https://nabtahealth.com/glossary/puberty/) in their toddler. But in reality, premature breast development in little girls is fairly common, with a peak incidence anywhere from 6 months to 2 years of life and the other around the ages of 6-8 years. Studies have shown that premature breast development affects about eight percent of white girls and more than 20 percent of black girls under 8 years old. Premature thelarche is the medical term for early breast development in girls under 8 years old without any other signs of sexual maturation. Little girls with this condition will have the onset of gradual breast development over a several month period. They will often complain that their breasts are tender to the touch. This can occur in both breasts or just one breast and may resolve spontaneously after a period of time. So what causes early breast development in little girls? There are a few possibilities: The breast tissue becomes extra sensitive to the normal estrogen that is in a little girl’s body. There is an imbalance in the ratio of estrogen to androgen, another hormone that produces sexual characteristics. The hypothalamic-pituitary-ovarian axis is too active. In other words, usually the [puberty](https://nabtahealth.com/glossary/puberty/) hormones in the brain are “turned off” until the onset of [puberty](https://nabtahealth.com/glossary/puberty/). In premature thelarche, it is thought these hormones are partially active. Obesity is another well-recognized cause of premature thelarche. Due to a complicated relationship with the adrenal glands and fat cells, there is an increase in estrogen production. Sometimes obesity alone can explain premature breast development in a young child. Occasionally, little girls who are exposed to too much estrogen outside their body can develop premature thelarche. Examples include: Ingestion of estrogen-primed foods Accidental ingestion of oral contraceptives Exposure to estrogen-containing creams Exposure to herbal medications, some of which mimic estrogen Exposure to certain hair care products that contain estrogen Once these outside estrogen sources are eliminated, most little girls will have a regression of their breast development. Infant soy formula has also been suggested to contribute to premature thelarche but there is insufficient evidence to recommend avoiding foods containing soy all together. Laboratory testing is usually not helpful in the investigation of premature breast development. The pediatrician may order a simple X-ray called a “bone age” to determine if your child’s bones are maturing too fast, a sign of true early [puberty](https://nabtahealth.com/glossary/puberty/). There is usually nothing to worry about if your little girl has premature thelarche. By definition, this condition is [benign](https://nabtahealth.com/glossary/benign/) and does not progress over time. However, a small percentage of girls will go on to develop other signs of early [puberty](https://nabtahealth.com/glossary/puberty/), so close follow-up is recommended. If your girl also develops other secondary sexual characteristics, such as underarm hair, pubic hair, rapidly increasing height, body odor, or acne, she should be evaluated by a pediatrician right away as these are signs of true precocious [puberty](https://nabtahealth.com/glossary/puberty/). **Sources:** * Pediatrics in Review * Gynecomastia and Premature Thelarche. Medscape * Precocious [Puberty](https://nabtahealth.com/glossary/puberty/). Saunders Manual of Pediatric Practice. Powered by Bundoo®
Chiropractors are the most commonly used alternative medicine providers for kids, and their popularity is growing. But is chiropractic care safe for kids? Does it work? Should families spend their money on chiropractic care as treatment for common childhood illnesses? Unfortunately, there are very few evidence-based research studies involving children to help answer these questions. Chiropractic medicine is a form of alternative therapy established toward the end of the 1800s. It’s based on practices that date back to ancient Greece. The primary principle of chiropractic medicine is improving the body’s ability to heal itself through adjustments of the spine and nervous system. In addition to the adjustments most people think of, chiropractors also provide services like heat/massage therapy, nutritional counseling, and ultrasound therapy for musculoskeletal conditions. Chiropractics in children used to be seen as an alternative treatment for kids with chronic conditions. But that practice has shifted. In a 2009 study, the primary reason for parents choosing chiropractic care for children was “wellness care.” Chiropractic offices may operate on their own or as part of medical practices or hospital systems. Depending on the state in which you live, chiropractors can perform school physicals. Some chiropractors combine chiropractic techniques with other forms of alternative medicine such as acupuncture. Doctor of Chiropractics (DCs) are not medical doctors, similar to dentists, psychologists, podiatrists, and optometrists. They have attended school specifically for chiropractic medicine. All 50 states license DCs to provide chiropractic care to children and adults. While any chiropractor may treat children, some take additional coursework to achieve pediatric certifications: Pediatric Fellow (FICCP)—a Diplomate chosen as a Fellow based on their years of experience, research papers, post-graduate teaching or other contributions. Pediatric Diplomate (DICPA or DICCP)—360 hours of coursework and exam, plus a research project. Pediatric Certified—May be CACCP, requiring 180 hours of coursework and exam (the current requirement) or FICPA, requiring 120 hours and exam. According to the American Academy of Pediatrics Task Force on Complementary and Alternative Medicine, few studies have demonstrated that chiropractic medicine provides any benefit for children. While severe complications are possible, they seem to be rare. And more studies are needed to determine the safety and effectiveness of chiropractic care in children. In the meantime, parents are cautioned not to rely only on chiropractic care for the treatment of conditions in children. In 2000, a study of 150 chiropractic practices in Boston found that “pediatric chiropractic care is often inconsistent with recommended medical guidelines.” **Sources:** * Alcantara J, Ohm J, Kunz D * The safety and effectiveness of pediatric chiropractic: a survey of chiropractors and parents in a practice-based research network * Explore (NY) * 2009 Sep-Oct;5(5):290-5 * doi: 10.1016/j.explore.2009.06.002 * PubMed International Chiropractors Association * Frequently Asked Questions. Pediatrics and Child Health * Chiropractic care for children: Controversies and issues. Pediatrics * The Use of Complementary and Alternative Medicine in Pediatrics. Powered by Bundoo®
Do you have a picky eater? A child who has a limited variety of food intake because he or she rejects unfamiliar foods? It’s not uncommon for children to go through a “picky phase,” but researchers aren’t clear about exactly how many children experience this common phenomenon. Picky eating typically begins during toddlerhood, between ages 2 and 6, which also happens to be a time when physical growth slows down. Because growth and appetite are closely tied, the toddler’s appetite naturally declines as growth slows. Picky eating often overlaps with normal emotional developmental milestones. Many toddlers are just beginning to assert their independence around this age, and food refusal can be another form of inserting independence. Picky eating can also be a way to assert power. Many toddlers also go through a phase of neophobia (fear of new food). Researchers do not fully understand why this happens. If you’re worried about malnutrition, it might be helpful to know that many toddlers meet their nutritional requirements in the first half or two-thirds of the day, especially if they are fed with structured meals and snacks. Often, dinner is the time when toddlers are most tired and least needy of nutrients. Some toddlers may eat only one good meal a day and pick at food the remainder of the day. What your toddler eats over the course of a week (21 meals and multiple snacks) is a better indicator of overall nutritional intake. You should make sure you keep offering appealing and tasty vegetables! Repeated exposure to food is the most studied avenue for addressing picky eating. Young children can require several introductions (up to 15 or more!) before they accept and eat certain foods. However, a 2012 Journal of Nutrition and Dietetics study of preschoolers in school showed that repeated exposure did not increase vegetable consumption. Children were more likely to eat vegetables when they saw their friends eating them. This study highlights the importance of role modeling, peer-to-peer influence, and a need for more research in this area. Nutrient-wise, fruit is a good stand-in for vegetables, so you don’t need to fret about vitamins and minerals. Letting your child serve himself, staying on a structured meal pattern during the day, and responding to your child’s appetite are just a few ways to keep the feeding dynamic positive. Unfortunately, some parents make picky eating worse with practices such as pushing more bites or pleading with a toddler to try something new. These practices, though well intentioned, tend to backfire with toddlers, making picky eating worse. **Sources:** * Savage JS, Fisher JO and Birch LL * Parental influence on eating behavior: conception to adolescence * J Med Ethics * 2007; 35 (1): 22-34. O’Connell ML, Henderson KE, Luedicke J, Schwartz MB * Repeated exposure in a natural setting: A Preschool intervention to increase vegetable consumption * J Acad Nutr Diet * 2012; 112: 230-234. Castle J * and Jacobsen M * Fearless Feeding: How to Raise Healthy Eaters from High Chair to High School * Jossey-Bass: San Francisco, CA, 2013. Powered by Bundoo®
There are many artificial sweeteners on the market today, and it can be confusing for parents to understand what they are and where they are found in food. Artificial sweeteners are generally created in a lab, with the exception of Stevia, which is extracted from a plant. Artificial sweeteners are substitutes for sugar with low or no calories. They are very sweet, and thus small amounts are adequate to match the sweetness of sugar. Manufacturers are required to list all ingredients for a product on the ingredient label, including artificial sweeteners. Nearly 180 million Americans eat and drink sugar-free products daily. The Food and Drug Administration ([FDA](https://nabtahealth.com/glossary/fda-2/)) regulates artificial sweeteners and has approved five artificial sweeteners for human consumption: Aspartame (known as Nutra-Sweet; Equal): Consumed by more than 200 million people worldwide, aspartame is found in sugar-free products such as carbonated soft drinks, powdered soft drinks, chewing gum, candy, Jell-O, dessert mixes, puddings and fillings, frozen desserts, yogurt, some vitamins and sugar-free cough drops. To find whether a product contains aspartame, read the ingredient label. Saccharin (known as Sweet-n-Low; Sugar Twin): This is the most studied artificial sweetener on the market. Most research was conducted in rats, where they found that male rats fed high doses of sodium saccharin had a higher risk of acquiring bladder tumors. However, extensive research in humans (over 30 studies) supports its safety when consumed in normal human doses. In fact, the National Cancer Institute states there is “no clear evidence that the artificial sweeteners available commercially in the US are associated with cancer rise in humans.” Saccharin is found in baked goods, chewing gum, jam, canned fruit, candy, dessert toppings, salad dressings, cosmetics and vitamins. Acesulfamide-K (known as Sweet One; Swiss Sweet; Sunett; Sweet-Safe): Ace-K is used in over 5,000 products in 100 countries and is 200 times sweeter than sugar. It is often found blended with other artificial sweeteners to create a cleaner sugar taste. Almost 100 studies have been conducted to assure its safety. You can find Ace-K in carbonated beverages, powdered beverages, fruit juice, dairy products, ice cream, desserts, Jell-O, fruit preserves, jam, jelly, baked goods, chewing gum, marinated fish, toothpaste, mouthwash, yogurt, breakfast cereals, snack foods, soups and more. Sucralose (known as Splenda): A no-calorie artificial sweetener made from sugar that is specially processed to remove the carbohydrate (and calories). It’s heat stable and can be used in baking and other cooking methods. More than 110 scientific studies have been conducted and sucralose is approved for use in over 80 countries and found in over 4,000 products such as yogurt, syrup, canned fruit, and ice cream. Neotame: The newest artificial sweetener approved by the [FDA](https://nabtahealth.com/glossary/fda-2/), it is 40 times sweeter than aspartame and is also used as a flavor enhancer. More than 100 scientific studies in animals and humans have been conducted to determine its safety. It is approved for use in beverages, gum, dairy products, frozen desserts and baked goods. It is heat tolerant and can be used as a stand-alone sweetener or blended with other artificial sweeteners. It is used in over 1,000 products worldwide. Generally Recognized as Safe (GRAS): Stevia: Found in a plant native to South America, Stevia is used as non-caloric sweetener and flavor enhancer. It was allowed as a food additive in 2008 and classified as Generally Recognized As Safe (GRAS). Two chemicals found in Stevia—stevioside and rebaudioside A—are regarded as “likely safe” for use as a sweetener. Stevioside has been studied only recently; rebaudioside A has GRAS status. You can find Stevia in beverages like bottled and flavored waters, juice drinks, sweetened tea drinks as well as ice cream, pickling products, colas, soy sauce, gum, canned foods, candy, yogurt and rice wine. **Sources:** * Aspartame Information Center * Consumer Products. Saccharin * History of Saccharin. Acesulfame Potassium * Products. Splenda * About Splenda. Neotame * About Neotame. National Cancer Institute. Powered by Bundoo®
The primary parenting goal during infancy is to form an attachment with your baby. This is easily done with feeding. Breastfeeding has been shown over and over to create an environment whereby mom and child attach, or bond. Bottle feeding can have the same benefits, if done with responsiveness. Responsive feeding is the process of recognizing your baby’s cues for hunger and fullness and responding to them appropriately (feeding baby or stopping). This process is active and interactive. The parent is actively paying attention to baby while feeding, reading cues and sending them back to baby. Baby communicates with the parent simultaneously through demonstrated interest in eating or not. Here’s a simple scenario of what responsive feeding looks like: Baby: Fussing and whining Parent: “You seem like you’re hungry—it’s time for lunch!” Baby: Leans forward for first bite. Parent: Feeds a bite of food and watches for baby’s response. Baby: Leans forward again with mouth open. This goes on for several rounds of back and forth with baby leaning in for another bite and parent feeding in response. Baby: Turns away from the spoon. Parent: Tries to offer another bite. Baby: Turns away and shakes head no. Parent: “Is your belly happy? It looks like you’re telling me you are all done.” The meal ends. The first step in being responsive is to recognize your baby’s cues for hunger and fullness. Research shows that most parents are pretty good at recognizing their baby’s hunger, but not at recognizing fullness. In fact, many parents will continue to feed baby even after clear signs of fullness. Some parents try to get the baby to finish a bottle or polish off the baby food jar. By doing this, parents disregard baby’s natural instinct to stop eating. In the long run, overfeeding your baby increases the risk for overeating and weight problems. Here are some common signs that baby is hungry or full: Hungry Fusses, whines or accelerates to crying Gnawing on hands, fingers or thumb Rooting Full Pulls off the breast or the bottle Turns away from spoon Bats at food Swipes food off tray or throws food Shakes head no. Each baby has his or her own signs for hunger and fullness, and it pays to learn these early on. You won’t always get it right, but if you pay close attention and use responsive feeding, chances are you’ll be on the mark most of the time. The best thing? Responsive feeding encourages parent and child to connect at meal times, while baby learns to regulate his or her own appetite. **Sources:** * Rees * Childhood Attachment * 2007 * Brit J Gen Pract; 57:920-922. Eneli et al * The Trust Model: A Different Feeding Paradigm for Managing Childhood Obesity * Obesity * 2008; 16:2197-2204. Black et al * Responsive feeding is embedded in a theoretical framework of responsive parenting * J Nutr * Published online January 26, 2011. Castle JL and Jacobsen MT * Fearless Feeding: How to Raise Healthy Eaters from High Chair to High School * Jossey-Bass, 2013. Powered by Bundoo®
The protein in whole milk is much larger and more difficult to digest than the proteins in breast milk and formula (yes, even in cow’s milk formula). By 12 months of age, the great majority of babies are now capable of safely digesting that protein, and therefore you can make the switch to regular milk. Signs that your baby is not ready to switch include a dramatic change in stools that includes mucus or milk, as well as an upset baby. There are also toddler formulas on the market, but with rare exception, there is no medical need to graduate first to these products. They are expensive and unnecessary at this time. Powered by Bundoo®
