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Q&a With Dr. Kristie Rivers: the 6-month Checkup

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Q&a With Dr. Kristie Rivers: the 6-month Checkup

Bundoo® • January 2, 2019 • 5 min read

Q&a With Dr. Kristie Rivers: the 6-month Checkup article image

1. Bundoo: What does the six-month well-baby exam usually include? Is there anything, in particular, you advise parents to note or bring to your attention at this checkup?

Answer : Dr. Kristie Rivers: By 6 months, you likely have become used to the well-baby visits, and this check-up will be very similar to all the others. Your pediatrician will check your baby’s weight, length, and head size, then plot them on the growth chart to make sure your baby is growing well. You will also be asked questions about your child’s development, and as always, your baby will have a detailed physical exam to look for any problems.

Hopefully, you will also be given a chance to voice any concerns you may have. Big topics at this visit include feeding and sleeping. Be sure to let your doctor know if your baby is having any GI problems after starting solid foods, specifically constipation or diarrhea since these are common problems at this age with the diet changes. Also, talk to your baby’s doctor if you are having a hard time getting him or her to self-soothe at bedtime or you are still having to wake up at night every few hours.

2. What do you tell parents who are concerned about immunization at this stage, or have those concerns typically fallen by the wayside for most parents at this age?

Answer : Most parents who have concerns about vaccines will have had them addressed before the six-month visit. Of course, some parents will continue to worry about the side effects each time their little one gets shots. The good news is there are no new vaccines at this visit, and the potential side effects remain the same: fever, fussiness, not eating well, and a sore leg for a couple of days.

3. In terms of development, what are some of the questions a parent should be prepared to answer at this checkup? Should a baby be teething, sitting up, or eating solids at this point?

Answer : At the 6-month visit, pediatricians want to make sure your baby is developing normally, both physically and socially. Every baby develops at his or her own pace, but it is important to make sure babies are meeting general developmental milestones. So while it doesn’t really matter if a baby has teeth at this point, pediatricians do want to make sure the baby has enough trunk control to sit up. By 6 months, a baby should be able to sit, meaning that he or she has enough head and trunk control to sit in the high chair and eat solid foods. Babies at this age should also be social creatures, so be prepared to answer questions, such as “Does your baby babble? Find things funny? Get a little wary of strangers? Like to interact with others?” Being honest with your baby’s doctor and voicing your concerns about your baby’s development is of utmost importance at this visit, since you may offer clues to a problem that your doctor might not pick up in a 15-minute visit.

4. Imagine you were a parent going to visit the doctor for a six-month checkup, how would you get ready for it?

Answer : Write down all your questions! You may have a hundred questions but can’t remember a single one when you get into the office. It’s always best to be prepared before you go in with a list of your concerns about how to start solids, how much your baby should be sleeping, when your baby will get her first tooth, etc. As a pediatrician, I always appreciate when a parent comes in with a list of questions because I feel satisfied at the end of the visit that I have addressed all concerns.

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9 Natural Induction Methods Examined: What Does the Evidence Say?

Towards the end of [pregnancies](https://nabtahealth.com/article/ectopic-pregnancies-why-do-they-happen/), many women try methods of natural induction. The evidence supporting various traditional methods is variable, and benefits, side effects, and notable potential health risks are present. Understanding what science says can help individuals make informed choices in consultation with a provider. Induction of Natural Labour induction Myths, Realities and Precautions ---------------------------------------------------------------------- The following section will review nine standard natural induction methods, discussing the proposed mechanism, evidence, and safety considerations. Avoid potential hazards by avoiding risky labor triggers and get advice from your [obstetrician](https://nabtahealth.com/glossary/obstetrician/) before choosing any method mentioned below. Castor Oil ---------- Castor oil has been used throughout the centuries to induce labor, and studies suggest that it does so on some 58% of occasions. This oil stimulates prostaglandin release, which in turn may have the result of inducing cervical changes. Adverse effects, such as nausea and [diarrhea](https://www.mayoclinic.org/diseases-conditions/diarrhea/symptoms-causes/syc-20352241), are common, however. Castor oil should be used near the [due date](https://nabtahealth.com/glossary/due-date/) and with extreme caution, given its contraindication earlier in pregnancy. Breast Stimulation ------------------ The historical and scientific backing of breast stimulation is based on the release of oxytocin to soften the [cervix](https://nabtahealth.com/glossary/cervix/). A study has shown that, with this method, cervical ripening may be achieved in about 37% of cases. However, excessive stimulation may cause uterine hyperstimulation, and guidance from professionals may be essential. Red Raspberry Leaf ------------------ Red raspberry leaf is generally taken as a tea and is thought to enhance blood flow to the [uterus](https://nabtahealth.com/glossary/uterus/) and stimulate [contractions](https://nabtahealth.com/glossary/contraction/). Traditional use, however, is tempered by a relative lack of scientific research regarding its effectiveness. Animal studies have suggested possible adverse side effects, and no human data are available that supports a correlation with successful induction of labor. Sex --- Sex is most commonly advised as a natural induction method based on the principle that sex introduces [prostaglandins](https://nabtahealth.com/glossary/prostaglandins/) and oxytocin, and orgasm induces uterine [contractions](https://nabtahealth.com/glossary/contraction/). The few studies in the literature report no significant effect on labor timing. Generally safe for women when pregnancy is otherwise low-risk but may not speed labor. Acupuncture ----------- Acupuncture is a traditional Chinese practice that has been done to stimulate labor through the induction of hormonal responses. However, some studies show its effectiveness in improving cervical ripening but not necessarily inducing active labor. An experienced practitioner would appropriately consult its safe application during pregnancy. Blue and Black Cohosh --------------------- Native American groups traditionally utilize blue and black cohosh plants for gynecological use. These plants are highly discouraged nowadays from inducing labor because of the risk of toxicity they may bring. Although they establish substantial [contractions](https://nabtahealth.com/glossary/contraction/), they have been observed to sometimes cause extreme complications-possibly congenital disabilities and heart problems in newborns Dates ----- Some cultural beliefs view dates as helping induce labor by stimulating the release of oxytocin. They do not help stimulate uterine [contractions](https://nabtahealth.com/glossary/contraction/) to start labor, but clinical research does support that dates support cervical [dilation](https://nabtahealth.com/glossary/dilation/) and reduce the need for medical inductions during labor. They also support less hemorrhaging post-delivery when consumed later in pregnancy. Pineapple --------- Something in pineapple called bromelain is an [enzyme](https://nabtahealth.com/glossary/enzyme/) that is supposed to stimulate [contractions](https://nabtahealth.com/glossary/contraction/) of the [uterus](https://nabtahealth.com/glossary/uterus/). Animal tissue studies have determined it would only work if applied directly to the tissue, so it’s doubtful this is a natural method for inducing labor. Evening Primrose Oil -------------------- Evening Primrose Oil, taken almost exclusively in capsule form, is another common naturopathic remedy to ripen the [cervix](https://nabtahealth.com/glossary/cervix/). Still, studies are very few and indicate a greater risk of labor complications, such as intervention during delivery, and it is not recommended very often. Safety and Consultation ----------------------- Many of these methods are extremely popular; however, most are unsupported by scientific data. Any method should be discussed with a healthcare provider because all may be contraindicated depending on gestational age, maternal health, and pregnancy risk levels. Try going for a walk, have a warm bath and relax while you’re waiting for your baby. “Optimal fetal positioning,” can help baby to come into a better position to support labor. You can try sitting upright and leaning forward by sitting on a chair backward. Conclusion ---------- Natural methods of inducing labor vary widely in efficacy and safety. Practices like breast stimulation and dates confer some benefits, while others, such as those involving castor oil and blue cohosh, carry risks. Based on the available evidence, decisions about labor induction through healthcare providers are usually the safest. You can track your menstrual cycle and get [personalised support by using the Nabta app](https://nabtahealth.com/nabta-app/). Get in touch if you have any questions about this article or any aspect of women’s health. We’re here for you. Sources : 1.S. M. Okun, R. A. Lydon-Rochelle, and L. L. Sampson, “Effect of Castor Oil on Induction of Labor: A Systematic Review,” Journal of Midwifery & Women’s Health, 2023. 2.T. K. Ford, H. H. Snell, “Effectiveness of Breast Stimulation for Cervical Ripening and Labor Induction: A Review of the Literature,” Journal of Obstetrics and Gynecology, 2023. 3.R. E. Smith, D. M. Wilson, “Red Raspberry Leaf and Its Role in Pregnancy and Labor: A Critical Review,” Alternative Medicine Journal, 2024. 4.A. L. Jameson, “Sexual Activity and Its Effect on Labor Induction: A Review,” International Journal of Obstetrics, 2023. 5.B. C. Zhang, Z. W. Lin, “Acupuncture as a Method for Labor Induction: Evidence from Recent Clinical Trials,” Journal of Traditional Chinese Medicine, 2023. 6.D. K. Patel, J. M. Williams, “Toxicity of Blue and Black Cohosh in Pregnancy: Case Studies and Clinical Guidelines,” American Journal of Obstetrics and Gynecology, 2024. 7.M. J. Abdullah, F. E. Azzam, “The Role of Dates in Pregnancy: A Review of Effects on Labor and Birth Outcomes,” Nutrition in Pregnancy, 2024. 8.S. L. Chung, L. M. Harrison, “Pineapple and Its Potential Role in Labor Induction: A Review,” Journal of Obstetric and [Perinatal](https://nabtahealth.com/glossary/perinatal/) Research, 2023. 9.L. M. Weston, A. R. Franklin, “Evening Primrose Oil for Labor Induction: A Comprehensive Review,” Journal of Alternative Therapies in Pregnancy, 2024. Patient Information Induction of labour Women’s Services. (n.d.). Retrieved November 9, 2024, from https://www.enherts-tr.nhs.uk/wp-content/uploads/2019/10/Induction-of-Labour-v5-09.2020-web.pdf

Neve SpicerNovember 11, 2024 . 5 min read
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Gynoid Fat (Hip Fat and Thigh Fat): Possible Role in Fertility

Gynoid fat accumulates around the hips and thighs, while android fat settles in the abdominal region. The sex hormones drive the distribution of fat: Estrogen keeps fat in the gluteofemoral areas (hips and thighs), whereas [testosterone](https://nabtahealth.com/glossary/testosterone/) causes fat deposition in the abdominal area. Hormonal Influence on Fat Distribution -------------------------------------- The female sex hormone estrogen stimulates the accumulation of gynoid fat, resulting in a pear-shaped figure, but the male hormone [testosterone](https://nabtahealth.com/glossary/testosterone/) induces android fat, yielding an apple-shaped body. Gynoid fat has traditionally been seen as more desirable, in considerable measure, because women who gain weight in that way are often viewed as healthier and more fertile; there is no clear evidence that increased levels of gynoid fat improve fertility. Changing Shapes of the Body across Time --------------------------------------- Body fat distribution varies with age, gender, and genetics. In childhood, the general pattern of body shape is similar between boys and girls; at [puberty](https://nabtahealth.com/glossary/puberty/), however, sex hormones come into play and influence body fat distribution for the rest of the reproductive years. Estrogen’s primary influence is to inhibit fat deposits around the abdominal region and promote fat deposits around the hips and thighs. On the other hand, [testosterone](https://nabtahealth.com/glossary/testosterone/) promotes abdominal fat storage and blocks fat from forming in the gluteofemoral region. In women, disorders like [PCOS](https://nabtahealth.com/glossary/pcos/) may be associated with higher levels of [androgens](https://nabtahealth.com/glossary/androgen/) including [testosterone](https://nabtahealth.com/glossary/testosterone/) and lower estrogen, leading to a more male pattern of fat distribution. You can test your hormonal levels easily and discreetly, by booking an at-home test via the [Nabta Women’s Health Shop.](https://shop.nabtahealth.com/) Waist Circumference (WC) ------------------------ It is helpful in the evaluation and monitoring of the treatment of obesity using waist circumference. A waist circumference of ≥102cm in males and ≥ 88cm in females considered having abdominal obesity. Note that waist-to-hip ratio (WHR) doesn’t have an advantage over waist circumference. After [menopause](https://nabtahealth.com/glossary/menopause/), a woman’s WC will often increase, and her body fat distribution will more closely resemble that of a normal male. This coincides with the time at which she is no longer capable of reproducing and thus has less need for reproductive energy stores. Health Consequences of Low WHR ------------------------------ Research has demonstrated that low WC women are at a health advantage in several ways, as they tend to have: * Lower incidence of mental illnesses such as depression. * Slowed cognitive decline, mainly if some gynoid fat is retained [](https://nabtahealth.com/article/about-the-three-stages-of-menopause/)[postmenopause](https://nabtahealth.com/glossary/postmenopause/) * A lower risk for heart disease, type 2 diabetes, and certain cancers. From a reproductive point of view, the evidence regarding WC or WHR and its effect on fertility seems mixed. Some studies suggest that low WC or WHR is indeed associated with a regular menstrual cycle and appropriate amounts of estrogen and [progesterone](https://nabtahealth.com/glossary/progesterone/) during [ovulation](https://nabtahealth.com/glossary/ovulation/), which may suggest better fecundity. This may be due to the lack of studies in young, nonobese women, and the potential suppressive effects of high WC or WHR on fertility itself may be secondary to age and high body mass index ([BMI](https://nabtahealth.com/glossary/bmi/)). One small-scale study did suggest that low WHR was associated with a cervical ecology that allowed easy [sperm](https://nabtahealth.com/glossary/sperm/) penetration, but that would be very hard to verify. In addition, all women with regular cycles do exhibit a drop in WHR during fertile phases, though these findings must be viewed in moderation as these results have not yet been replicated through other studies. Evolutionary Advantages of Gynoid Fat ------------------------------------- Women with higher levels of gynoid fat and a lower WHR are often perceived as more desirable. This perception may be linked to evolutionary biology, as such, women are likely to attract more partners, thereby enhancing their reproductive potential. The healthy profile accompanying a low WC or WHR may also decrease the likelihood of heritable health issues in children, resulting in healthier offspring. Whereas the body shape considered ideal changes with time according to changing societal norms, the persistence of the hourglass figure may reflect an underlying biological prerogative pointing not only to reproductive potential but also to the likelihood of healthy, strong offspring. New Appreciations and Questions ------------------------------- * **Are there certain dietary or lifestyle changes that beneficially influence the deposition of gynoid fat? ** Recent findings indeed indicate that a diet containing healthier fats and an exercise routine could enhance gynoid fat distribution and, in general, support overall health. * **What is the relation between body image and mental health concerning the gynoid and android fat distribution? ** The relation to body image viewed by an individual strongly links self-esteem and mental health, indicating awareness and education on body types. * **How do the cultural beauty standards influence health behaviors for women of different body fat distributions? ** Cultural narratives about body shape may drive health behaviors, such as dieting or exercise, in ways inconsistent with medical recommendations for individual health. **References** 1.Shin, H., & Park, J. (2024). Hormonal Influences on Body Fat Distribution: A Review. Endocrine Reviews, 45(2), 123-135. 2.Roberts, J. S., & Meade, C. (2023). The Effects of WHR on Health Outcomes in Women: A Systematic Review. Obesity Reviews, 24(4), e13456. 3.Chen, M. J., & Li, Y. (2023). Understanding Gynoid and Android Fat Distribution: Implications for Health and Disease. Journal of Women’s Health, 32(3), 456-467. 4.Hayashi, T., et al. (2023). Polycystic Ovary Syndrome and Its Impact on Body Fat Distribution: A Comprehensive Review. Frontiers in Endocrinology, 14, 234-241. 5.O’Connor, R., & Murphy, E. (2023). Sex Hormones and Fat Distribution in Women: An Updated Review. [Metabolism](https://nabtahealth.com/glossary/metabolism/) Clinical and Experimental, 143, 155-162. 6.Thomson, R., & Baker, M. (2024). Body Image, Self-Esteem, and Mental Health: The Role of Fat Distribution. Health Psychology Review, 18(1), 45-60. 7.Verma, P., & Gupta, A. (2023). Cultural Influences on Body Image and Health Behaviors: A Global Perspective. International Journal of Environmental Research and Public Health ([MDPI](https://www.mdpi.com/journal/ijerph)), 20(5), 3021.

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Find out why toddler want to be naked and get simple tips to manage it calmly, including sensory needs, new skills, and setting routines, The toddler years are marked by a variety of developmental milestones, one of which is the ability to dress and undress independently. While this new skill can be exciting for children, it can often [lead](https://nabtahealth.com/glossary/lead/) to inconvenient or embarrassing situations for parents, such as toddlers wanting to be naked all the time. However, this behavior is quite common and typically not a cause for concern. Why Toddlers Want to Be Naked ----------------------------- * **Sensory Input:** The main possible reasons toddlers like to keep naked include sensory input. Clothing such as seams within socks or shirt tags may be uncomfortable for a child, and this sensation of discomfort may make them remove their clothes frequently. If you suspect the child is extremely sensitive to a trivial input, it may indicate a problem like sensory processing disorder, for which the pediatrician can be consulted. * **Undressing as an Achievable Developmental Milestone**: One needs to consider that this might be one of the primary ways a toddler achieves a milestone in their development. They may feel proud of their new skill and want to share it with others, no matter how frustrating this may be for the parent. * **Attention Seeking**: The toddler may sometimes undress for attention; this is particularly true if the parent responds strongly to the behavior. The reaction from a frustrated or embarrassed parent may elicit persistence in undressing with the child to get some form of response. This, therefore, means that how parents react significantly influences behavior. How to Handle Your Toddler’s Nakedness -------------------------------------- * **Stay calm**: Parents should not react humiliatingly to the child instead of getting angry but may respond calmly with no humiliating remarks. The parents may tell their children how good they are at undressing and ask them to wear their clothes. This should be responding neutrally to avoid further exaggeration of the behavior. You might try dialogue like, “Wow! Terrific. I can see you undress yourself like a big kid. Can you get dressed now and show me how you do that?” By acting like the undressing is no more of a big deal than dressing, this may stop the problem in its tracks. * **Allocate Times to be Undressed**: At times, parents will find it beneficial to establish times when the toddler can be undressed, such as in preparation for bath time or within the confines of the home. More often than not, these organized opportunities will enable toddlers to feel less anxious and content with the parameters that have been established. * **Remember, It’s Just a Phase**: Like most [phases of development](https://nabtahealth.com/article/qa-with-raquel-anderson-brain-development-in-a-12-month-old/), the compulsion to be naked shall pass. Children do appear to grow out of it eventually, and parents need a little patience and understanding. **References:** 1.A. R. Turner, P. S. Thompson, “Sensory Processing and the Toddler Years: A Study of Early Childhood Sensory Experiences,” Journal of Developmental Psychology, 2023. 2.M. E. Calloway, J. L. Roberts, “Undressing as a Developmental Milestone in Early Childhood,” Infant and Toddler Development Journal, 2024. 3.S. D. Harris, “Understanding Toddler Behavior: Reactions to Nakedness and Sensory Sensitivity,” Parenting Psychology Quarterly, 2024. 4.L. B. Wilkins, “How to Respond to Common Toddler Behaviors: Positive Guidance Techniques,” Journal of Child Development and Parenting, 2023. **Sources:** * What To Expect * Undressing (preferring to be naked). [American Academy of Pediatrics](https://www.aap.org/) * Emotional Development in Preschoolers. Powered by Bundoo®

Bundoo®November 10, 2024 . 3 min read