Q&a With Dr. Sara Connolly: Everything you Need to Know About Your 4-week Check-up
Bundoo® • January 2, 2019 • 5 min read
1. Bundoo: Most babies will visit their pediatrician at 1 month for a check-up if they haven’t already been into the doctor’s office. What are you looking for at the 1-month well-baby check-up?
Answer : Dr. Sara Connolly: Pediatricians love to see babies at 1 month old! Depending on your office, your child may receive their second hepatitis B vaccination at this visit. In addition, there are many issues to discuss. Foremost in our minds is the opportunity to evaluate growth and feeding. For most mothers, breastfeeding is getting easier at this point, so we want to check in to make sure this is true for you and your baby. If not, we can help new moms stay committed to nursing. For both breastfed and formula-fed babies, we want to make sure the baby is gaining weight, growing longer, and that their head is growing well. By this time, there are often new questions about sleep, fussiness, rashes, and stooling patterns, so these can be addressed as well. Finally, we want to know that new families are doing okay. We ask about the adjustment to a new member of the household and how the mother is feeling.
2. Most babies receive their first Hepatitis B vaccine at birth, with a follow-up shot at 1 month. What would you say to a parent who was worried about this vaccine?
Answer : It is important to address any vaccine concerns parents have at each visit. While an infant typically receives Hepatitis B at the 1-month visit, they will receive several vaccines at the 2-month visit, so beginning this discussion early is best. Parents should feel free to bring up any concerns with the doctors. They should know that fever and soreness at the injection site are possible, and they should know what to do if they occur. They should know that the hepatitis B vaccine is a safe and effective cancer prevention vaccine as hepatitis B leads to liver cancer.
3. What questions should parents have for their doctors at the check-up?
Answer : Parents should ask about how well their child is gaining weight. They may want to discuss their baby’s stooling patterns as they can change dramatically between the first days after birth and now. If their baby is spitting up or uncomfortable with feeding, those issues should also be addressed. As families are usually beginning to leave the house more, they may want to ask about travel or how to prevent infections as they venture out into the world. If a family is struggling with bonding, depression, food insecurity, homelessness, or anxiety, be sure to tell the doctor. Parenting an infant is difficult, and there are many resources out there for people who are struggling, but we can’t always tell just by looking at you!
4. What’s the most common concern you hear from parents that they probably shouldn’t be worrying about at this point?
Answer : Parents are always worried about the frequency of stooling. Either they believe the baby is pooping too much or too little. Babies vary so much in how often they poop at this age, but often it is much less frequently than just a week or two ago, which is why they worry. If a baby is comfortable, eating well, and gaining weight, then how often they poop is unimportant. Some babies will stool three times a day or more, and some will not stool every day or even every other day. As long as when it comes, the poop is soft and like paste, then there is nothing to worry about.
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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
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.
Why Does my Toddler Want to be Naked? (2024)
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®