Maternity Insurance|Maternity Care|Postpartum Care

Postnatal Depression

The symptoms of postnatal depression appear any time before and after delivery of your baby. Around 1 in 7 (14%) of women will develop postnatal depression and 10% experience symptoms during the pregnancy (antenatal depression).

Antenatal depression is often overlooked. A pregnant woman that is feeling overwhelmed and anxious for more than two weeks and cannot function in day to day activities may be suffering from antenatal depression. The risk factors for developing antenatal depression are listed below. Approximately half of women with antenatal depression will develop postnatal depression.

• Complicated, unwanted or unplanned pregnancy.


• Discontinuation of medications.


• Family history of depression.


• Lack of support or financial concerns.


• Previous infertility.


• Relationship difficulties.


• Stressful life events.

In post natal depression the symptoms might appear suddenly or take some weeks or months to become evident. Post natal depression is known to occur after miscarriage, stillbirth or delivery. It is most commonplace with the first baby but can occur with any pregnancy.

The risks posed by post natal depression are significant. Partners and family members are asked to monitor the woman for signs of suicidal thoughts, self harm, harm to the baby or substance abuse.

Causes of Postnatal Depression

Postnatal depression doesn't have a sole cause. A number of risk factors combine to cause depression and anxiety. The most common causal factors for post natal depression are having a family and personal history of depression, a stressful pregnancy, severe 'baby blues', a complicated or prolonged delivery and problems with the neonate's condition.

Signs and Symptoms of Postnatal Depression

The signs and symptoms of post natal depression are the same as for general depression. These are listed below.

• Always exhausted or hyperactive.


• Anxiety or panic attacks.


• Confusion and guilt.


• Constantly thinking in a negative way.


• Crying uncontrollably or feeling teary.


• Eating too little or too much.


• Feeling scared and alone, but not wanting company.


• Forgetfulness.


• Inability to enjoy life.


• Insomnia.


• Irritable or sensitive to noise or touch.


• Loss of confidence and low self esteem.


• Loss of interest in sex.


• Moodiness.


• Poor concentration.


• Poor coping skills.


• Preoccupied with obsessive or morbid thoughts.


• Thoughts of self harm or harm to the baby.


• Unrealistic feelings of inadequacy.

Assessment of Postnatal Depression

Recording a complete physical, social and family history is a good place to start the assessment. The symptoms of post natal depression are examined specifically after the general history and diagnostics are obtained. A self rating scale is used to screen for postnatal depression and measure the severity of the depression.

A common scale is the Edinburgh Post natal Depression Scale (EPDS). A score of 10 or more indicates the woman may be depressed and the woman should be referred to a psychologist or psychiatrist for diagnosis. The EPDS is a useful comparator of the woman's depression over time when administered regularly.

Diagnosis of Postnatal Depression

The actual diagnosis of post natal depression is straightforward. Basic diagnostic tests are used to rule out any possible underlying source of depression. The clinician examines in detail the stressors in the woman's life. The major obstacle is trying to convince women to seek help.

Women with antenatal depression are likely to conceal their symptoms and carry on regardless. There is a misconception that motherhood is easy and a joyful experience. This is the case for some women but other new mothers do not share this experience. The stigma of mental illness adds to the depression.

Complications of Postnatal Depression

Left untreated, post natal depression has a negative impact on the women's relationship with her baby, partner, family and friends. Most women with postnatal depression express that they love their child but a connection between mother and baby has not been established.

Postnatal depression doesn't resolve on it's own. If the depression is not identified, it cannot be treated. The post natal depression will linger and possibly reappear as another form of depression in later life. Most women completely recover from post natal depression without any long term complications.

Treatment of Postnatal Depression

Postnatal depression responds well to a combined treatment strategy consisting of emotional support, psychological support and medications. Antidepressant medication is the mainstay of treatment. Most women will remain on antidepressants for six months to two years. Women with postnatal depression should be informed that antidepressants are not addictive and can be taken safely during breast feeding.

Cognitive behaviour therapy is an effective therapy for relieving depression and anxiety by providing the individual with realistic strategies to manage their illness. This encourages self management of stressful events and depression.

Hospitalisation is indicated when a woman is suicidal, a risk to herself or others or if medical care has not achieved mood stability. Ideally the mother and baby are admitted to a mother-baby unit. A woman in postpartum psychosis is admitted to a mental health facility without her baby until the psychosis has been resolved.

For many women giving birth is a happy time of their life. For others, however, symptoms of depression and panic attacks can occur so strongly as to drastically affect their lives.

Postpartum disorders occur in one in every eight women, so if this your case, you are clearly not alone.

These symptoms go far beyond the typical baby blues that many mothers experience but rather they are intense feelings of not being able to cope and not feeling like you.

What can these women experience?

These new moms worry about really harming their children. This is a large part of the cause for the anxiety as even picturing harming a child can cause anyone to feel just horrible.

Furthermore, the anxiety of raising a child, because of the feeling of not being adequate to the job, is also a contributing factor.

Such questions as how to provide proper care and nutrients to the child just keep swimming in the postpartum mothers mind.

While this depression and postpartum anxiety continues to rage on the feelings will compound, and the situation will just get worse. This is why it is absolutely crucial to seek help at the very first signs of postpartum depression!

Can Postpartum Panic Attacks Be Helped?

Fortunately, postpartum depression can be reversed, and the anxiety attacks that come with this condition, can also be treated. This is certainly not a new disorder and many Mothers go through the same feelings after giving birth.

So What Are The 3 Ways to Deal with Postpartum Panic Attacks?

1.) The best way to start to deal with postpartum panic attacks, are to recognize them for what they are and to seek out a local support group. Just talking to other mothers can reassure you that you are not going crazy.

Furthermore, these groups help to realize that these feelings do not make you a lousy mother.

2.) Another way to deal with these anxiety attacks is to seek out professional medical care. Now obviously you are nursing so the medications you take will have to be taken into account.

Just using some simple and homeopathic remedies has been proven to help many mothers with postpartum depression. As well as relaxing exercises such as some light Yoga or any other relaxing exercise could be very helpful.

3.) The last way is to seek out cognitive therapy and interpersonal therapy. The way this helps is that cognitive therapy helps to overcome negative perceptions, which can result is a lack of energy and depression.

While interpersonal therapy can overcome immediate and difficult problems also help with difficult transitions such as giving birth.

Is This a Common Condition?

While postpartum depression may not be all that common, it is vitally important that you and your family recognize the symptoms of this disorder. Once you have the ability to spot yourself falling prey to this disease it will be easier to seek out the best treatment.

There should never be any stigma associated with seeking out help when you are facing this difficult situation.

Far too many times tragedy has struck many families because they either did not know about this disease or were unwilling to seek out treatment because of the fear of being judged harshly by others.

Cerebral palsy, which is a medical condition, occurs because of brain damage. It also occurs because of improper brain development. Brain development in a human being occurs right from the time of conception by the mother, as the fetus begins to show signs of growth. The brain is the most important organ because it almost controls everything in the human body. Any small damage to the brain can cause tremendous harm to any part in the body. If damage happens in the part of the brain cells that control the nerves and muscle coordination then the child will be born with cerebral palsy.

Damage to the brain of a child can occur anytime while the fetus is growing in the mother's stomach, during birth or right after birth due to various reasons. If the mother has a bad fall which directly results in causing brain damage to the fetus then cerebral palsy can occur. At times during birth, doctors tend to use forceps, a kind of medical instrument used for delivery on the head of the baby. When used with slight force it can cause damage to the brain. Also during birth or while in the stomach just before delivery, due to the mother's high blood pressure, the baby can be deprived of the much-needed oxygen that goes to the brain and this too can lead to cerebral palsy.

It is also possible that the umbilical cord connecting the baby and mother can get entangled around the neck of the baby and thus cause strangulation. This will result in the baby not getting enough oxygen to the brain and this will lead to certain cells in the brain to die a natural death because of lack of oxygen, which is so important for its survival. Leaving the baby too long inside the womb as soon as the child is ready for delivery is likely to cause cerebral palsy in the new born infant.

All these are instances of medical negligence and it is because of this that a cerebral palsy attorney is most required if your child is born and diagnosed as having cerebral palsy. It is the bounden duty of the medical fraternity to make sure that you have a safe pregnancy and the child in the womb is safe. In addition, they should ensure that the baby is born without facing any problems so that it stays healthy and does not end up with this medical condition.

The world over, there are thousands of children who are born with this medical condition and in many cases it is due to the negligence of the medical fraternity. Proper care during pregnancy, excellent delivery methods, and proper postnatal care is all very essential to the safety of the child. If malpractice and negligence is found to be the cause then legal remedy is to be sought, at once and a n attorney needs to be consulted. The attorney will call for all the records and then file lawsuits on behalf of the aggrieved parents. The attorney will fight the case in a court of law and get adequate compensation for the parents so that the money would be useful to help maintain and provide excellent treatment procedures for their affected child.

Baby formula was originally intended to be a milk substitute for women who couldn't breastfeed. Today, it is peddled as the next best thing to mother's milk, suggesting that it is just as healthful as breast milk, Health care providers often promote bottle feeding by giving free samples of formula to new mothers.

Yet, no man made concoction can duplicate the properties of breast milk, no matter how many supplements are added to it. Breastfeeding offers many benefits that formula cannot deliver.

Breastfed babies get fewer ear infections and other infections, due to antibiotics in breast milk. They get less diarrhea, constipation, colic, and other stomach upsets. They have a reduced risk of SIDS (sudden infant death syndrome). Breastfed babies tend to have straighter teeth and don't get "baby bottle syndrome" (buck teeth from bottle). Breastfeeding satisfies the baby's emotional needs and increases bonding between mother and baby. And breastfed babies smell better, from top to bottom, but especially the bottom.

Some benefits to breastfed babies are lifelong. In later childhood, there is a decreased risk of tooth decay, diabetes, and some childhood cancers. As adults, they will have fewer allergies. In fact, it has been estimated that 65% of bottle fed babies will develop a lifelong allergy. Adults who were breastfed tend to have lower cholesterol levels; are less likely to be obese; are less likely to have high blood pressure, and are less likely to have heart disease. They will have a reduced risk of: rheumatoid arthritis and osteoporosis, compared to adults who were bottle fed. The antibodies in breast milk seem to last a lifetime, as adults who were breastfed are less likely to have ear infection, or other infections;

Breastfeeding also benefits the mother greatly. It helps delay the return of fertility and to space subsequent pregnancies. It reduces the risk of postnatal depression, and helps to develop an emotional relationship and bonding with her child. Breastfeeding helps the uterus contract after birth to control postpartum bleeding. Nursing mothers get more rest than bottle feeding moms, as there is no screaming baby in the middle of the night waiting on the formula to heat up; you can nurse while sleeping. Both mom and baby sleep better. Dad sleeps better to, since he never has to get out of bed to help with feeding. Breastfeeding mothers have less chance of breast cancer, as well as some other forms of cancer throughout life. Breastfeeding reduces the risk of osteoporosis in later years. Above all, breastfeeding gives you the satisfaction of knowing you are giving your baby the best start in life.

Disclaimer: This article is for entertainment purposes only, and is not intended for use as diagnosis or treatment of a health problem or as a substitute for consulting a licensed medical professional.

During pregnancy, the baby is like a parasite and will take all the nutrients that he requires from you. If your diet is sufficient in nutrients for both, it does not cause any problems. If on the other hand your diet is insufficient for both, then your recovery after the birth will take longer and if you still do not replenish your body stores during the confinement period, you may remain weak for a long time. This is probably why our elders make such a lot of fuss about eating well during the confinement period.

Wherever you are in the world, everyone will try and tell you what to eat and if possible how to eat it. The most important thing to do is follow your own body's needs. Whatever you eat, do make sure that you have a good balance of proteins, vitamins, minerals, fats, carbohydrates, and water in every meal.

Just remember the following pointers:

1. If you are breast feeding whatever you eat will be transferred to your baby via your breast milk therefore it is important that you eat a balanced diet so that your baby will get the right nutrients for optimum growth and development.

2. Some food does cause the baby to become 'windy' or have loose stools. If you find that your baby is suddenly quite unsettled, try and think of what you ate during the last 12 hours. Avoid that food for a few days and then try again. If the same happens again, then you should avoid that particular food for a while and re-introduce it into your diet by taking a very small amount and see how baby reacts then slowly increase the amount so that baby gets used to the food.

3. You may find that your appetite is slightly low especially during the first week. This is normal as your body is readjusting to its non-pregnant state both physically and mentally therefore it is better to have small frequent meals instead of the normal 3 big meals a day.

4. You need to drink plenty of fluids in order to make sufficient breast milk and if you are forbidden to drink water, you can get the amount of fluid from other sources such as soup.

So what should you eat?

Most Eastern cultures believe that your body is cold after delivery therefore you should avoid cooling or cold food but eat a lot of yang or 'heaty' food to warm the body up. However, if you are normally a yang person, eating too much 'heaty' food may cause rashes and fever. In this case it would be better to reduce the amount of 'heaty' food and eat more neutral food. If you are normally a Yin person, you should not have any problems eating 'heaty' food (lucky devils). The following table gives you a quick review of the types of food to eat or avoid.

Types of food to avoid

'Cooling food' for example: banana, cabbage, cucumber, coconut and Chinese cabbage
Contribute to mother's poor blood circulation and stomach ache in the baby if you are breastfeeding. Salt as a condiment and salty foods in general are to be rejected, too, in the belief that use reduces breast milk production

'Acidic food' for example: pineapple, mango, lemon, lime
Contribute to excessive lochia in the mother and diarrhea in the baby.

Too much 'Heaty food' for example: chilli, pepper, spices, tonics, spirits and medicines.
Contribute to diarrhea in the baby and maternal headaches

'Windy food' for example: jackfruit, tapioca, pumpkin, onions.
Contribute to baby being colicky and may cause indigestion for mother and baby.

Poisonous food such as prawns, shellfish, crab, eel, ginger
Delay healing of the mother's wound and may cause allergies and eczema in the baby. These foods may cause stomach upsets and vomiting

Type of food recommended

To improve milk production

Chicken, squid, clams (small varieties), fish (especially carp), millet, mutton, pork, rice wine, sea slug, soybean milk mixed with powdered walnuts, wheat cakes, wheat noodles with egg, green papaya

To provide strength to the mother so she recovers quickly from the exertion of labor.
Chicken, frog, Panax ginseng, licorice extract and razor clam

What you eat also depends on what you believe in and who cooks for you. If it is your mother or MIL you may not have many choices. I have seen women quarrelling and not talking to each other because of this issue. Try and work out a compromise which is acceptable to both parties. Use a persuasive and logical approach instead of confrontation.

Focus on a Complete Solution, not Just Software

Typically, PTs begin a technology initiative by calling a list of selected vendors. Usually, their first question is, "Do you offer scheduling or documentation?" This leads to a discussion about the features and before you know it, the process becomes a scavenger hunt. To find a comprehensive solution, ask questions like, "How can you help me manage my practice?" or "What can you do to help me reduce my claim denials?" Asking these types of questions will focus the search on real practice solutions.

Identify and Leverage Growth Opportunities

Physician referrals are one of the keys to success in private practice. Here are a few steps to help make you a more attractive option to referring physicians:

• Market your niche - When marketing yourself to physicians, hone in on your area of expertise, such as sports medicine or knee rehabilitation.

• Communicate with referring physicians - Keep the lines of communication open by leveraging electronic communication. This demonstrates your responsiveness and professionalism to the physician.

• Get online - Many patients research their therapy options online on evenings and weekends. Having a website for your practice and even a patient portal gives you an edge over the competition.

Reduce Appointment No-shows and Cancellations

The ultimate solution to the no-shows problem requires a practice-wide commitment. In today's busy world, people need constant reminders. Everyone organizes their personal calendar in their own way. Some prefer a reminder letter while others respond best to phone messages and many prefer electronic reminders via text or email. A multi-channel reminder program can work wonders in lowering your no-show rate.

Deliver all Authorized Care

When a patient receives an authorization for a set number of visits and you fail to complete those visits, the patient loses out on care and you lose out on revenue. Having a comprehensive patient compliance program in place is essential to your success. A crucial component of that program is the multi-channel reminder program discussed above.

Once you have the patient there, it's important to make sure you get paid for the care you deliver. The most efficient way of keeping track of authorized visits is to use a system that can automatically track the number of remaining authorized visits and deducts each visit against the correct authorization.

Incorporate Technology at the Point of Care

In recent years, electronic medical record (EMR) systems have been proven to help physical therapy providers enhance care, rather than hinder the interaction with the patient. For example, automated documentation prompts users for measures during an evaluation so they can focus more on the patient without having to remember the next steps in the documentation process.

Having a physical therapy EMR that prompts users for specific measures at the point of care can actually help providers work faster, raise the quality of care, collect more revenue and eliminate the human errors that can easily occur during documentation.

Avoid the Payer Reimbursement Downward Trend

Politics, budget shortfalls and skyrocketing healthcare costs are all driving public and private payers to take an aim at providers. In addition to focusing your management attention and resources on ways to increase payer reimbursement, here are a couple of ways you can make improvements in your practice:

• Make co-pay collection automatic - Incorporate a system that automatically reminds front desk staff to collect patient co-pays so they don't fall through the cracks.

• Speed up Physical Therapy Documentation - Use an EMR system for documentation to help dramatically speed up the documentation process, improve accuracy, decrease the time it takes to submit claims and receive payer reimbursement.

Understand the Difference Between Billing and Revenue

Many physical therapists tend to look at billing as the "moneymaker" of the practice and build their office technology around whatever comes with the system. However, even the best billing system can only submit the claims for the work you've done. The real revenue comes from building a solid referral network, retaining patients, reducing appointment no-shows, accurately capturing and coding every treatment you provide and increasing staff productivity. All this can be accomplished with a physical therapy management solution in place.

Don't let Paper and Cumbersome Process Take over Your Practice

Many private practice owners don't realize the cost involved with paper processes. Consider all the costs associated with paper documentation - the time it takes to manually document, the human errors that result in claim denials, filing time, the floor space needed to store files and the cost of paper and files. It all adds up to a fortune! This can all be prevented with electronic documentation.

To thrive in today's challenging environment, physical therapy providers need to respond to both what payers are doing, and what they can do to drive efficiency in their practice. The challenge is you don't have many chances to get it right. Today, many practices and hospitals rely on innovative technology. There are many resources available in the market. However, going with a physical therapy EMR will be the best option for an all-encompassing practice management solution.

Many persons see postpartum depression as an illness affecting just the mother. Unfortunately, this is not the case. The whole family encounters relationship issues that alter family dynamics considerably. Depressed mothers who do not seek treatment often place their infants in danger of experiencing severe or deadly delays in growth and development.

The medical name for this complex problem is non-organic failure to thrive. Non-organic means that there is no medical cause for the infant's delays. As a result of the mother's postpartum depression, she often fails to care for the baby's nutritional and emotional needs. Even though the infant may cry out in hunger at first, he or she often loses interest and stops relating to other people. This disorder may result in malnutrition, starvation, or even death.

Physicians use growth charts to follow a baby's physical growth in height, weight, and head size. If the infant is healthy at birth, his or her size fits within the normal values on these charts. If the infant starts to have severe growth delays, the problem will appear when comparing his or her development against normal growth charts. If the baby's progress is below the fifth percentile, doctors get worried.

Other signs often appear before the baby's growth problems reach this crisis stage. Most infants who grow at a normal rate are curious about their surroundings. In contrast, infants who do not thrive have little or no interest in their surroundings. These infants typically do not make noise or words; they have quit trying to respond to their caretakers.

How serious is this condition? If not treated properly, a child may starve to death. Even if the baby grows enough to remain alive, his or her heart, lungs, and brain do develop properly. Furthermore, even if they are treated, these children never "catch up" entirely. They often acquire social problems or eating conditions, even after they begin to have their needs met.

Babies who failure to thrive often become critically ill from starvation. They usually are in the hospital for several weeks at a time. In some cases, they become so weakened that feeding from a bottle is too tiring. They get feedings through a tube inserted in their stomachs, or even in a vein to get food!

The saddest aspect of this condition is that it is so preventable. If mothers with postpartum depression identify this problem at its onset, they can get treatment and never expose their fragile babies to these terrible dangers. Indeed, studies have shown that nine-tenths of the women who suffer from depression who get treatment will find healing!

A variety of approaches is used to treat postpartum depression. Many doctors use medications, such as antidepressants. These medicines are costly. They should also be avoided in nursing mothers. Moreover, antidepressants can cause thoughts of suicide; these medications should be prescribed with extreme caution.

Usually, doctors recommend psychotherapy instead of or along with medications. Counseling, however, can be expensive. In addition, it can be time-consuming, and several weeks may go by before this therapy begins to help. Regrettably, depending on the severity of the woman's depression, this much time may be too much to prevent harm to the infant. If the baby begins to experience delayed growth, extra therapies may be required.

Luckily, other non-drug treatment options can be used. Two innovative, beneficial methods that typically yield results much more quickly than psychotherapy, and are much less dangerous than medication, are Neuro-Linguistic Programming, or NLP and hypnotherapy for depression. NLP and hypnosis usually begin to work after only one session. In addition, they are much less expensive than alternative methods.

Mothers who think they might have postpartum depression need to get treatment at once so that their infants are not at risk for critical growth problems. The severity of the consequences for the infant mandates that any approach work quickly, and have a high rate of effectiveness. NLP and hypnosis for depression are inexpensive, work quickly, and are highly effective. Therefore, both of these treatments are perfect for treating postpartum depression.

Summary: Postpartum depression is depression that begins after the birth of a child. New moms cannot provide their infants the caring they must have to survive and grow. This results in failure to thrive, a severe, potentially deadly disorder, which hurts the baby. Women who think they might have postpartum depression need to seek treatment immediately. Hypnosis and NLP for depression are inexpensive and have demonstrated amazing effectiveness.

The saying is that an ounce of prevention is worth a pound of cure, and this is very true when it comes to the baby blues. It's very normal for new mothers to have some ups and downs in the early weeks after a baby is born. In fact, these ups and downs are pretty normal throughout your baby's first year of life. There are specific steps you can take to make it less likely that these normal feelings will develop into a lasting case of mild depression, or the baby blues, however.

Get Enough Sleep

I know this one is hard. In fact, I'm a mother of five. I really understand that getting enough sleep is hard. But as a mother of five I know the wisdom of the advice "sleep when the baby sleeps." You want to get as much sleep as you can. At the very least you should try and take one nap a day with your baby. You can do this throughout your child's early years (toddlers are pretty tiring too!).

If you have older children, keep them occupied while you have a short nap period. You can put a toddler safely into a playpen or crib with some toys, then lie down with the baby. You can nap while an older child is in school or preschool, or if you homeschool, schedule a quiet work period for your child while you nap.

It can be hard to fit this time in if you return to work after your baby is born. Try to make sure you're getting this nap while you're on maternity leave. If your baby is very wakeful at night after you return to work, you may want to try and take a few minutes to relax at your desk each day. Listen to a guided relaxation on headphones to relax your muscles and get some rest.

Eat Really Well

You need to eat well to take care of a baby. Pregnancy is a time of nutritional stress - your baby needed a lot from your body and your body changed a lot for him or her. After pregnancy you need to build back up your nutrient stores while taking care of a needy baby. If you're breast feeding your baby you will need good nutrition to keep your milk supply strong for your little one.

Eating well means trying to eat simpler, homemade foods. Get plenty of protein. Did you know that your body needs healthy fats for energy and fuel? Your brain and your baby's brain need a lot of fat. It's believed that one of the reasons mothers feel the baby blues or experience stronger postpartum depression is because of deficiency in essential fats. You may have heard a lot of joking about "mommy brain" -- where suddenly your brain is always foggy and you can't quite think clearly. These are also signs of a need for more fats. Get good fats like coconut oil, olive oil, animal fats, and full-fat dairy. Industrial fats like corn oil, margarine, and soybean oil are bad for your health. Fatty fish and pastured beef (cows raised eating grass) have lots of Omega-3 fatty acids, which you need a lot of.

Also get plenty of vegetables and eat fruits in season. These will give you vitamins and minerals you need (again, you need fat to make sure your body absorbs them).

It's OK to Let Thing Go

Remember that being a mom is a big job. It's okay to take a break from things. Don't feel obligated to make it to all six mommy groups every week. If you need to use paper plates and plastic utensils in the early weeks, do it without guilt! Keep the bathroom and kitchen clean, but really, you don't need your house to look like company is coming all the time. Scale back volunteering and other things until your baby is a few months old and you've adjusted to life as a new mom. Keeping a low-key, predictable routine will go a long way towards enhancing your sense of well-being.

Giving birth is one of the most beautiful processes of life and evolution, yet for some new mothers there is a catch. Feelings of sadness or anger after childbirth create a true struggle in the lives of many women, and may occur within 2 days of birth as pregnancy hormones suddenly drop and the new mother comes to the realization that there is now a new baby in need of constant attention. Following delivery, approximately 80% of first time mothers experience a decrease in mood sometimes referred to as the "postpartum blues," while 13% of new mothers experience a major depressive episode within a few weeks after childbirth known as postpartum depression (Wisner et al., 2002). For some women the understanding that hormones and fatigue are the driving factors in this process is important, but many mothers feel guilty about having these symptoms, thinking they are not good mothers or not "cut out" for motherhood. If you are a new mother, remember you are not alone as hundreds of thousands of women in the United States each year experience postpartum depression. Women with a previous history of depression are at a particularly high risk for depression (Wisner et al., 2002). Additional risk factors include conflict with the baby's father, stressful life events and child care stresses. As more women seek drug-free treatment for pregnancy related conditions, the ancient Chinese healing art of acupuncture can support, nurture and ease the transition into motherhood while supporting the overall lifestyle of the new mother.

Postpartum is one of the most critical times for a woman to receive regular preventative care from a Chinese medical practitioner. Acupuncturists can often offset years of "suboptimal" lifestyle and stress in the first few weeks postpartum, as well as intercept abnormalities in lochial flow to rectify years of menstrual irregularities and prevent them from occurring. Acupuncture works on the normal recuperative cycle of a woman to counteract the effects of postpartum depression. In addition to restoring a mother's energy levels after the stress of birth and alleviating depression and anxiety, acupuncturecan be used postpartum to relieve backache, perineal or other kinds of pain.

It is important to lay out some solutions for new mothers to consider as we move into this phase of life that can greatly improve symptoms related to postpartum.

Nutrition
Once a baby is born it is common for the new mother to focus so much on the health of the newborn that she forgets how important it is to nourish herself. Remember, the nutrients the mother gets are translated to the baby through breast milk. Therefore it is extremely important for the mother to eat a diet rich in fruits and vegetables and low in sugar and caffeine. Some babies will not like the taste of breast milk or may have
changes in their digestion after the mother eats certain foods which are important to be aware of. Even if a new mother is not breast feeding, her diet can greatly reduce mood swings as the physical body is strong and full of nutrients.

Exercise
Who has time to exercise? We hear this so frequently in our clinic, but exercise for a new mother can be as simple as taking a daily walk with your newborn in a stroller. Fresh air and movement are unparalleled in their ability to regulate mood. Other ways of exercising with a newborn are home exercises such as yoga poses, push ups and stomach crunches. These can be done throughout the day in 30 second intervals which will keep a new mother from having to carve out time to do them. Holding a pose, 20 push ups or 25 stomach crunches 15 times in a day is a total of 7 minutes and 30 seconds of exercise which can have incredible benefits to postpartum depression.

Supplements/Herbal Therapy
Taking supplements or herbal therapies is an all natural way to gently support mood and calm the mind. While some herbal therapies will affect the taste of a woman's breast milk, an experienced herbalist should be able to create a formula which will benefit both the mother and the baby. Important supplements to consider include:
- Multivitamin: a good quality vitamin is essential
- B-Complex: B vitamins are essential for boosting mood, but they are assimilated by the body as a complex, so taking one specific B vitamin is not very effective.
- Flax Seed Oil: most babies dislike the taste of their mother's breast milk if they are taking fish oil pills so substituting flax or borage oil can be a simple solution.
- 5-HTP: commonly used supplement for depression that is converted to serotonin with the help of B vitamins

Acupuncture/Massage
These therapies are extremely supportive and nurturing to a new mother's overall lifestyle. It is very important for new parents to make time for supportive lifestyle activities that can bridge the gap through difficult periods. Acupuncture balances out Heart and Liver deficiencies which become prevalent after childbirth along with balancing the constitutional pattern of the individual mother.

Rest/Time with your partner
New mothers need sleep for physical and mental recovery. This is easier said than done with a newborn that needs to feed every 2 hours, but consider your support group and don't be afraid to leave your baby for periods of time. Family members, doulas and friends may be able to help offering a new mother time with her partner, times to nap uninterrupted or time to rejuvenate for a few hours.

Dongguan is located in the Pearl River Delta and is a major city in China. With four districts, this metropolis has become an international industrial and major economic center, attracting enormous foreign-direct investment. This city has a pleasant climate and is known for its long coastline and seafood varieties.

Taking a look at the city's health care facilities, it is obvious that its enterprising spirit is not limited to industrial and economic development. Although the city has many well-equipped hospitals, only some major medical centers can provide services with English-speaking staff. The following is a description of two leading hospitals.

Dongguan City People's Hospital (Red Hospital) located at 88 Tong sand in Wan Cheng Bei Yu, came into existence in 1888 as the Chinese Rhenish Church Lifeline Hospital and has witnessed several name changes before receiving its present name in 1988. Investors poured a large amount of capital for the hospital's modernization. As a result, this medical center has become the largest integrated health care facility in the region. This-patient centered hospital is situated in a lovely area, embellished with beautiful gardens and immaculate lawns. It employs a large, competent staff; includes 1500 beds for inpatients and provides contemporary and holistic quality-health care in all medical specialties. Dongguan City People's Hospital has achieved the prestigious three, A-level rating by the Health Ministry, as well as the provincial honors of Civilized Hospital Award and the Advanced Unit of Health Award.

Their outpatient department, established in 1930, is well organized and has special acupuncture, massage, and ECG treatment rooms. The surgery division has well-equipped units assisting many specialties. There are 15 advanced operating rooms featuring laminar flow and imported instruments, all manufactured by global companies. The center is particularly well known for various transplantations, advanced cardiac surgery, laparoscopy, arthroscopy and hysteroscopy. Its advanced emergency department features emergency surgery, observation room, pediatric unit, infusion area, various emergency tests, first aid services and state-of-the-art equipment. Managed by 50 experienced professionals, this department is available 24-hours a day. Other acclaimed departments utilizing advanced medical equipment, include ICU, radiology and ultrasound. Telephone: 22223412.

Global Doctor Dongguan Clinic is another preferred hospital for foreign dignitaries and visitors. This clinic resides at No. 30 IEO International Block in Dynatown. Established in 2005, and owned by Global Doctor, the acclaimed global health care and emergency assistance provider, this medical facility offers comprehensive medical service in all major specialties including family medicine, dentistry and acupuncture. It employs experienced, foreign doctors and English-speaking staff. Medical consultations are available in various languages like English, German, Spanish and Portuguese.

The center also offers round-the-clock medical advice, house call services, antenatal and postnatal care and also conducts many occupational health and annual medical programs. The Dongguan Clinic offers good surgical services in all major areas and provides pharmaceutical, laboratory and x-ray assistance. It offers excellent emergency services through the Global Doctor Beijing Response Center and offers referrals, medical evacuations and repatriation. This hospital also has associations with international insurance companies and is a member of the renowned International Assistance Group (IAG). Telelphone: 22030011.

Postnatal depression is estimated to affect 1 in 5 women and is found in all cultural, social and age groups. There are different types of this condition experienced by mothers after birth. There is the 'Baby Blues' which usually occurs between the 3rd and 5th day and usually resolve by the 10th day. It is thought to be the response to hormone changes and the stress of giving birth and occurs in up to 70% of women.

• Postnatal depression has a gradual onset between the 3rd and 9th month.


• Postpartum Psychosis occurs in approximately 1 in 500 births and is quite rare. It seems to be genetically linked and typically occurs after the first baby. It presents as a manic depressive illness and requires urgent psychiatric treatment.

This condition results in a disturbance of mood, disturbance of thoughts and physiological disturbances. These disturbances and symptoms of postnatal depression will be discussed:

Disturbance of Mood

This includes the experience of a depressed mood, feelings of sadness, hopelessness, worthlessness, failure, shame, guilt, fear, anger and panic. Feelings of fatigue and exhaustion and the loss of sexual desire.

Disturbance of Thoughts

Poor concentration, loss of ability to plan and carry through tasks, poor memory, confused thinking, intrusive thoughts (eg thoughts of serious illness or death of self, baby or partner).

Physiological disturbance

The mother may experience sleep disorder such as difficulty falling asleep, early morning waking, always fatigued and exhausted. She may also experience stress symptoms such as panic attacks, tightness in the chest and stomach. Appetite changes, either a loss of appetite or overeating may be experienced.

Risk Factors

A number of factors are thought to contribute to postnatal mood disorders. Current research indicates that psychological, biochemical and environmental or social factors affect the onset of postnatal depression.

There are a number of factors that predispose a woman to this condition. One of the most significant risk factors is having a previous psychiatric illness or emotional problems. Women who have previously had depression, anxiety and bipolar disorder are at a greater risk.

Obstetric and gynecological problems impact a mother's physical health and can impact her emotional well being. This can include caesarean birth, permittivity, previous miscarriage, previous termination of pregnancy, neonatal death, and previous history of infertility.

If the baby or mother has problems post birth this can also increase the possibility of postnatal depression. Problems such as the baby experiencing gastric reflux, excessive crying, breastfeeding problems, sleep deprivation, low iron levels.

In addition environmental and relationship factors can impact a mother and predispose her to postnatal depression. Lack of support from ones partner or own mother can be significant. This may be through death, separation or conflict in the relationship. Furthermore a mother's isolation from extended family or friendship network can impact postnatal depression. This can be significant particularly for first time mothers who may shift from a busy life in full time work to being isolated at home. Women who would describe themselves as high achievers or perfectionists are at greater risk of postnatal depression as are women with anxious personalities. Finally if the woman experiences multiple stressors in her past or present life these may contribute to the onset of postnatal depression.

Whether your journey here has been slow and torturous or brutally quick, you have arrived at a diagnosis of postnatal depression. If you have self-diagnosed, through a variety of research and checklists, your next step may be to decide whether or not to take this to your doctor. If it was your doctor who helped you come to the conclusion that you are suffering from PND, they will have run through your treatment options and are waiting for you to decide which route to follow.

Please note that I am NOT a medical practitioner, and the suggestions I make below are all dependent on your seeing a GP for professional guidance.

I'm scared to see a GP - they'll make me take drugs!

No ethical medical professional will ever force you to go down a treatment route that makes you uncomfortable or goes against your wishes. Just because you present with symptoms of PND does not mean they will force you to take brain-altering medication. They will give you the facts - how they normally treat women with PND, what the pros and cons are of each type of treatment, success rates, etc. If they do not readily offer this information, ask. You may find it helpful to prepare a series of questions and take them with you in a notebook. Sometimes talking to a stranger about our rawest emotions can be overwhelming and it's easy to forget what we really want to know.

How do I know if antidepressants are right for me?

Honestly? You won't know until you try. Sometimes our resistance is really about coming to terms with the fact that we're not very well. It can bring up a lot of guilt and shame and sense of failure.

"If I was a good mother I wouldn't need to take medication to feel better".

"As a new mother I should be blissed out on love for my son/daughter - if I start popping pills it means I don't love my baby enough".

It might seem hard to separate the issues, but your anxiety about motherhood and a sense of failure or guilt needs to be addressed while you are getting better. Taking antidepressant drugs does not mean you are a bad mother. Seeking help to improve your psychological wellbeing is actually a sign that you care enough about your baby to be emotionally there for them. This is the case whether you take medication or choose an alternative route. What matters is that you are actively helping yourself to improve your situation.

If I choose to take antidepressants, won't I get hooked?

A lot of people worry about this one. I certainly did before deciding to give them a go. It's true that you need to take your medication for a sustained period of time for it to be effective. Many GPs will recommend you continue for six months after you feel better to ensure the symptoms don't return. During this time (typically a year or two) your body will get used to the chemical mix in your system. So it's normal to worry that you will become dependent on them to feel normal. Talk to your GP upfront about your worries. They should be able to tell you the likelihood of experiencing difficulty reducing your dose or any withdrawal symptoms people may experience.

It used to be very common a few decades ago to experience difficulties coming off medication - but scientific advances, combined with a wide range of different types of antidepressants on the market, mean that it's less of an issue. Your GP should also be able to tell you how they help others reduce their dose, and how long their patients tend to take before coming off them completely. Fear of becoming dependent is perfectly legitimate, but don't let it paralyse you into inaction.

What reactions can I expect when I first take them?

Depending on the type of antidepressant you are prescribed, you may experience a variety of symptoms, from insomnia and heart palpitations to fatigue and restless legs. Your GP should let you know before you start your course what physical and psychological reactions you might expect. Most reactions last just a few days, and should level out within the week. If they continue beyond this time, or you experience severe anxiety or mood swings, go back to your doctor, who may try you on a different type of medication.

It's normal to feel frustrated if this occurs - having made the decision to take antidepressants, you want them to take effect as quickly as possible, and trying different types can feel like you're taking one step forward and three steps back. But if you find the right one, you should start to feel your mood lifting after about 10 to 14 days. When you're desperate, that can feel a lifetime away, but if you can ride it out, there should be light at the end of the tunnel.

What if I decide not to take antidepressants?

If you research the various types of medication your GP suggests and decide not to go down that route there are other avenues open to you to help you feel better. A non-exhaustive list of options includes:

Alternative remedies -The best known and researched is St John's Wort, a herbal compound that has been shown to have similar mood-lifting properties of chemical antidepressants with fewer side effects.

Food and exercise -Good nutrition and exercise will help improve low mood in those with mild anxiety or depression. Foods said to improve depression include garlic, oily fish, brazil nuts and coffee (in moderate doses). To make a difference to mood, exercise should increase the heart rate, such as swimming, running or walking fast. Bear in mind, however, that recent research has shown that exercise only helps mild to moderate depression and has no effect at all on severe depression.

Talking therapies- Many people taking conventional antidepressants will benefit from talking therapies such as counselling or CBT (cognitive behavioural therapy) and they should be seen as complementary to all types of treatment, rather than a straight alternative. However, if you are sure you do not want to take any kind of medication, it is important to acknowledge and treat your condition in some way. Talking to someone about your feelings should help you identify areas of change and see more clearly what action you can take to turn things around.

Taking medication for postnatal depression is very common, but please remember it doesn't mean you have failed as a mother. Rather, it can offer you the emotional resilience to see your situation more clearly and work out what actually needs to change in your life, providing your with the energy and motivation to carry those things out. Once you are able to make those changes, your need for medication will reduce, and your ability to accept and manage your emotions and behaviour will radically improve.

Tashkent translates to the "stone city". This city is the capital of Uzbekistan and one of the oldest cities in Central Asia. Tashkent has many mosques and religious sites and is often referred to as the cultural capital of the Islamic world. The city is modern, but maintains much of its heritage as well. The health care sector in Tashkent is in a developing phase and you have to look to major private hospitals for quality health care. This is a note on some of Tashkent's leading hospitals.

Tashkent International Medical Clinic situated at 38, Sarikul Street is a famous hospital in the international community of Tashkent. A well-known chartered non-governmental organization in the country established this center in 1994. The clinic is specifically designed to provide medical service at global standards to the international community in Uzbekistan. The staff members of foreign embassies, international representatives, along with other expatriates and their families in Tashkent are regular visitors to this hospital. It provides good diagnostic and therapeutic service in fundamental medical specialties. It employs an internationally trained staff and all the hospital services are readily available in English and other languages.

The dental unit treats all types of dental, oral disease and facial injuries. They also have an orthodontist on staff. Complete vaccination programs are also available. The center offers many health promotion programs and packages including weight control, immunizations, antenatal and postnatal care. It has a modern emergency center that has physicians accredited by the U.S. in advanced life support. It also offers medical evacuations to members. It has a good pharmacy and laboratory. Additionally, the clinic possesses ECG, modern X-rays, Pulmonary function test, audiogram and ultrasound diagnostic facilities. Tel: 998 71 291 0142

MDS-Services hospital is another modern hospital and is situated on Botkin Street in Tashkent. This private hospital founded in 2004 offers effective medical service by employing many well-trained doctors. It has well equipped departments in all medical specialties. It has clinics for diabetes, infertility, epilepsy, allergy, obesity and more. The therapeutic department on the second floor has 12 beds. The language of service is Russian and Uzbek.

An operating unit featuring two operation theaters offers effective surgical service in all major areas. It is known for advanced video laparoscopy and endoscopy. It has a modern emergency department, ambulance services and an intensive care unit. Tel: 269-7085

If you have ever had Malay massage, you already know how good it feels to have someone systematically relax your muscles one by one. The effects may last for hours, or even days. What you might not know is that having a massage can actually help you in many other ways.

A number of cultures have practiced massage therapies throughout history. One reason people get massages is to simply relax. Another reason is to help relieve stress. The actually benefits of getting a massage, however, go much farther. Massage therapy can help people with physical and even emotional problems. When it relaxes tense muscles, people are often relieved of physical discomfort in many different areas. Sometimes they feel relief in areas they did not even realize hurt in the first place. Those who work hard at their jobs often enjoy stress-relieving massages. Expectant mothers have also found that a relaxing massage can help them cope with the anxiety they feel over the new life they are creating. It can also help mothers who have recently had babies deal with the depression that is often part of the after affect of a new birth.

Overall, massage can help the lymphatic system get a jump start. That will aid the immune system and even improve the metabolism with a large number of other benefits. Those who are trained to give massages know exactly how to relieve stress throughout every inch of the body. These professionals know how the muscles within the body interact and they know how to smooth the stress that forms between those muscles. People that do not regularly get massages often do not realize how much the tension they feel in their muscles can really affect their daily life. The hidden discomforts can cause poor sleep, anxiety, weight gain, depression and a number of other problems. If you are able to remove the tension, your mind can often relax as well and you might even see your mood improve along with your physical benefits.

There are many different types of Malay massage and you will need to find the one that is right for your situation and lifestyle. You can visit a clinic, but if you are not comfortable in that type of setting, you can even have a massage in your own home. You may have to try a couple of different professionals before you find one that suits what you need, but it will be worth the effort.

Establishing a postpartum plan of care is essential for a healthy recovery following childbirth. A woman experiences many changes in her body during pregnancy and childbirth, most notable is her posture. The postpartum process is the period of recovery for the mother that begins as soon as the baby is born.

During the first six to eight weeks after delivery, the mother may experience a variety of physical symptoms including sore breasts, hip soreness, vaginal bleeding or soreness from an episiotomy or vaginal tear, problems urinating or with bowel movements, and even hair loss or skin changes.

Chiropractic can play an important role in managing a healthy postpartum recovery. Consulting with a chiropractor and developing a postpartum plan of care can help speed the recovery process and provide for optimal postpartum health. Chiropractic is an all-natural healthcare practice, which focuses on hands-on techniques, natural therapies, proper diet and nutrition, and the overall health and biomechanics of the body as a whole.

During an initial chiropractic postpartum examination, a chiropractor will review daily lifestyle activities since the delivery. These may include: diet, hydration, sleeping patterns, and level of activity. It is important for a new mom to create an approved exercise program, stay hydrated, get as much sleep as the newborn will allow, and eat the right kinds of foods. For example, drinking plenty of water and eating foods high in fiber can help women with voiding issues.

Home exercise programs such as Kegels and exercises that strengthen the core are also important for optimal postpartum recovery. Core strengthening exercises can be completed in as little as five minutes a day and may include exercises as simple as controlled breathing techniques and stretching exercises. These beginner exercises are not strenuous and can be performed early in the postpartum period. In fact, many of these can be performed while the mother is holding and caring for the baby. Thus, the mother can still use the baby's sleep time to attend to other important matters, such as the mother's own sleep time.

As the postpartum period progresses, the mother can transition into more active home exercise programs to strengthen her core. Indeed, she will need this strength to have the energy to lift and carry her baby, and later to keep up with the baby as the baby moves into the toddler years.

For women who experience certain pain and/or dysfunction during the postpartum period, adjustments and other physiotherapy modalities used by chiropractors can help safely and gently return lost function and relieve pain. In addition, a mother receiving chiropractic care will be less inclined to need pharmaceuticals for her pain or dysfunction, which is particularly important for women who are breastfeeding.

Establishing care through a chiropractor is beneficial on many levels. Chiropractors provide personalized care, specifically designed for each patient's needs and goals. The health benefits received from chiropractic during postpartum care can greatly improve the speed and quality of recovery. Moreover, it provides the foundation for a healthy and active lifestyle.

It is well known that vitamin D deficiency is associated with osteoporosis, bone fracture, increased falls, muscle weakness, increased risk of certain cancers (particularly breast and colon, and possibly prostate), autoimmune diseases, obesity, insulin resistance and type 2 diabetes, schizophrenia, depression, asthma, lung dysfunction, influenza, kidney disease, high blood pressure, and cardiovascular disease. Even complications of pregnancy, preeclampsia (pregnancy-induced hypertension) and gestational diabetes, are associated with vitamin D deficiency. In infants, the vitamin's insufficiency has also been linked to low birth weight (caused by low levels from the mother during pregancy) neonatal hypocalcemia (low blood calcium), poor postnatal growth, bone fragility, and increased incidence of autoimmune diseases and childhood asthma.

Prevention of Osteoporosis

The standard recommended dose of 400 IU/day of vitamin D was in general to help maintain "good health," and to help reduce the risk of osteoporosis, falls, and hip fractures. Over the last 5 years, there has been an explosion of studies expanding our knowledge and indicating that higher doses have much more of an effect on overall health and on the prevention of various chronic diseases than just bone development and the prevention of osteoporosis. This was standard while I was practicing medicine to recommend calcium, magnesium, and vitamin D to women of menopausal age. However, I now recommend doses much higher than 400 IU/day.

Insulin Resistance

A common problem I saw in my medical practice, associated with aging and increased weight was insulin resistance, which often led to metabolic syndrome or full-blow Type 2 diabetes. To help reduce the risk of diabetes, metabolic syndrome, and insulin resistance I would encourage my patients to maintain a low-glycemic diet, exercise at least 4 times a week, and be on a broad spectrum nutritional supplementation program. Often this made the difference for people who took it seriously and made significant changes.

Insulin resistance begins with oxidation of insulin receptors. Anything that cause more oxidation, and therefore more inflammation, can lead to insulin resistance, and ultimatley Type 2 diabetes. Continued consumption of high-glycemic food (simple sugars and starches) will damage insulin receptors via inflammation/oxidation. With continued oxidation and inflammation of insulin receptors full-blown Type 2 diabetes develops. Lately, it has been discovered that vitamin D deficiency is a contributing cause to insulin resistance, giving further support to my recommending higher doses.

Although not all studies have been consistent and demonstrating a reversal of insulin resistance with vitamin D supplementation, the studies that have shown benefits in reversign insulin resistance have been the studies demonstrating blood serum 25-hydroxvitamin D (or 25-OH-D) concentrations that were at least in the range of 35 - 42 ng/ml. This may suggest that high doses may be needed to see a benefit in the prevention, and possible reversal of insulin resistance.

Decreased Risk of Breast and Colon Cancer Associated with Supplementation

As a former practicing board-certified Ob/Gyn, I had many patients who had a history of breast cancer, or a family history of breast cancer. Colon cancer was also a concern, as its incidence is second to breast cancer. A decreased risk of breast and colon cancer (and possibly prostate cancer) has been associated when blood serum levels of 25-hydroxvitamin D (25-OH-D) are 40 ng/ml or above. For most women, this would require a dailly dose near 4000 IU/day.

I had many patients using tamoxifen to treat or suppress the recurrence of breast cancer. However, tamoxifen has its own concerns (among them possible endometrial cancer). Interestingly, much like drugs that are used to treat breast cancer, such as tamoxifen, vitamin D enters breast cancer cells and triggers apoptosis; whicself-destruction, or "cellular death," of cancer cells. Actually, several various antioxidants; e.g., turmeric extract, polyphenolic compounds; such as grape seed extract, cruciferous extract, resveratrol, green tea extract, and olive extract) all cause apoptosis, or cellular self-destruction. The benefit of apoptosis compared to chemotherapy drugs and radiation therapy is that it causes cancer cell dealth without toxicity or destruction to normal cells.

Although the knowledge and use of antioxidants to kill cancer cells is as of yet limited, and thefore too early to be used to replace current toxic therapies for cancer, there is much promise for vitamins and other antioxidants in the near future. According to the research, I am a believer that antioxidants, and like substancs may help to prevent to the initiation of cancer, and therefore, along with a proper diet and lifestyle, everyone should be taking quaility supplements.

Specifc to this article, as I have searched to find out what dose of vitamin D women "should be" taking for preventative measures against breast, ovarian, and colon cancer, I have discovered that the studies have shown an association between women whose serum 25-OH-D levels of at least 52 ng/ml or higher and a 50% decreased incidence of breast cancer. Ovarian and colon cancers are similar in that there is a significant decreased incidence when 25-OH-D levels are above 50 ng/ml; and particular when they reach 80 ng/ml.

As I speak on the "Power of Nutritional Supplementation," both in lectures and on my audio CD, I suggest that among other nutrients, when one considers there are so many potential health benefits to be obtained from nutritional supplementation of specific vitamins, let alone a full-range of quality supplements, with virtually no toxic effects, I have to ask why would anyone wait to supplement?

Reduced Risk of Heart Disease Associated with Vitamin D

Vitamin D deficiency increases the risk of both ischemic and non-ischemic heart disease. Supplementation also helps control blood pressure, it influences parathyroid hormone levels, influences the function of heart muscle, and plays a role in reduction of inflammation and calcification of blood vessels, thus helping to reduce atherosclerosis.

The risk for heart disease is particularly high when 25-OH-D blood levels are below 15 ng/ml. With 25-OH-D levels above 30 ng/ml cardiac benefits may possibly be significant. Obviously, more studies are needed to draw conclusions about this vitamin's role in maintaining and/or reducing cardiovascular disease, but once again, I can only say that there is now enough evidence when taken as a whole, for everyone to consider supplementing with adequate doses of this all-important vitamin for any or "all" of the potential health benefits.

Reduced Risk of Influenza with Vitamin D

It is well established that vitamin D reduces the incidence of respiratory infections. Children who have been found to have the lowest 25-hydroxyvitamin D blood levels are 11 times more likely to develop respiratory infections. I have been asked about the safety and effectiveness of children supplementing with this vitamin. One can only look to clinical information. Children with recurrent respiratory infections have been given as high a dose as 60,000 IU of vitamin D3 (the active form) each week (for six weeks), and found to have not one such infection for the following 6 months!

Many people suffer and die from influenza, or the "flu." They don't die of the viral infection per se, as much as they die from the body's over-reaction. The influenza virus causes an uncontrolled over-production of inflammatory cytokines. Interestingly, vitamin D turns down this process by "down regulating" the expression of pro-inflammatory cytokines, such as tumor necrosis factor-alpha.

Actually, the pro-inflammatory cytokine process is the same inflammatory process that occurs in chronic disease, such as inflammation of arteries in atherosclerosis, inflammation in arthritis, damage to neurons, and inflammation and damage caused by cancer cells and by the aging process itself.

Think about the possibilities of reducing inflammation, by down regulating cytokines (tumor necrosis factor alpha, etc.) and thus reducing the incidence and progression of many chronic degenerative diseases, including heart disease, cancer, Alzheimer's disease, arthritis, diabetes, respiratory infections, liver and kidney disease, and the aging process itself!

Regarding vitamin D (really a hormone) and the protection of respiratory infections and influenza, in addition to the down regulation of inflammatory cytokines, this unique hormone also up-regulates the expression of anti-microbial peptides in immune cells. Anti-microbial peptides damage the outer lipid membranes of influenza viruses, bacteria, and fungi allowing the white blood cells (macrophages) from the immune system to eliminate them from the body.

I suggest that adults and children supplement with much higher doses than what was has been traditionally recommended to reduce the incidence of respiratory infections and help support the immune system, particularly during winter months when exposure to sunlight is decreased.

Vitmain D May Help Reduce the Risk of Complications of Pregnancy

Maintaining health during pregnancy is a chief concern of mine because it is critical that women get proper cellular nutrition throughout their pregnancies. Optimal supplementation should take place before a woman even knows she's pregnant. This is one reason why I recommend all women of child-bearing age be on a full-spectrum of quality nutritional supplements. Now, with recent information about the benefits of vitamin D during pregnancy, the amount of vitamin D in prenatal vitamins is quite inadequate,...at least in my opinion.

Vitamin D plays a key role for calcium metabolism during pregnancy and development in order to prevent infantile rickets and adult osteomalacia. During pregnancy, calcium demands rapidly increase, particularly in the third trimester. Because of this, vitamin D, which is required for calcium incorporation into the bones becomes crucial for proper skeletal growth and optimal maternal and fetal outcomes. Despite widespread use of prenatal vitamins containing what is thought to be "adequate" doses of vitamin D, there is still a vitamin D deficiency epidemic among pregnant and lactating women.

It is even more important that a pregnant woman have optimal vitamin D blood levels than a non-pregnant woman, as her baby's health depends on it,...not only during fetal life, but during the next two decades of that baby's life!

Low vitamin D levels during pregnancy and infancy are associated with maternal preeclampsia and pregnancy-induced hypertension, neonatal low birth weight and hypocalcemia, poor postnatal growth, bone fragility, and increased incidence of autoimmune diseases and asthma of the child.

During pregnancy a minimum blood level of vitamin D (25-hydroxyVitamin D) should be at least 32 ng/ml or greater; and optimally closer to 50 ng/ml. In order to achieve and maintain 25-hydroxvitamin D serum levels at 32 - 50 ng/ml, I suggest that pregnant and lactating women would possibly need to supplement with a dose between 2000 and 4000 IU/day of vitamin D3 per day, which is both safe and effective. Of course, this is beyond the level found in all prenatal vitamins.

Childhood Asthma Linked to Vitamin D Deficiency

The asthma epidemic may be explained in part by the vitamin D deficiency epidemic. There is a direct correlation between low serum vitamin D levels and higher risks for asthma exacerbations. Vitamin D plays a role in fetal lung growth and development. Epidemiologic evidence suggests that higher prenatal vitamin D intake has a protective role against wheezing illnesses in children. Vitamin D may protect against wheezing illnesses through its multiple immune effects as discussed above. In addition, vitamin D may play a therapeutic role among asthmatics from becoming steroid resistant.

Above I indicated that vitamin D plays an important role in reducing the risk of respiratory infections. In children, and adults for that matter, with asthma, supplementation with high dose vitamin D is of even more importance, as a respiratory infection can trigger attack.

Measuring Your Vitamin D Status

The question on most people's mind is, "How much vitamin D is the right dose?" The best way to know one's "correct" dose is to know your 25-hydroxyVitamin D blood level. This is the metabolically-active form of vitamin D, and is also known as calcidiol. It is abbreviated as 25-OH-D. In the past, "adequate" blood levels were set to prevent rickets and then osteoporosis. The myriad benefits and safety of vitamin D is coming to light.

Most laboratories have a normal reference range for 25-OH-D of 32 - 100 ng/ml. After studying what many of the experts in the field of vitamin D deficiency treatment have recommended, it varying widely, I am in line with suggesting that one's "optimal" serum 25-OH-D level should be between 50 - 80 ng/ml.

What Dose of Vitamin D is Optimal?

The vitamin D dose required to attain a serum level range of 50 - 80 ng/ml will vary from person to person, mostly based upon body mass (weight) and sun exposure. Although this will vary considerably, a 150 lb person who supplements with 2000 IU of vitamin D per day may attain blood level range of 25-OH-D between 30 and 45 ng/ml, depending upon sun exposure. In my experience, it seems that this same person may need to take 4000 IU/day, or more, to attain optimal blood levels between 50 and 80 ng/ml.

Again, from my experience, and it this will vary widely. A person who weighs 225 lbs. may require a dose of 10,000 IU/day to maintain 25-hydroxyVitamin D blood serum levels between 50 and 80 ng/ml. A person's true dose can only be determined by blood tests and titration (adjustments based upon the blood tests).

My suggestion would be to start with vitamin D at either 4000 to 6000 IU/day, depending upon your weight; or you may safely opt to take 10,000 IU/day, and then have your 25-OH-D blood level tested about 6 to 8 weeks later. Your optimal blood level target range for optimal health is 50 - 80 ng/ml. Therefore, once you know your blood level, you may adjust your daily vitamin D intake accordingly.

Are High Doses of Vitamin D Safe?

Is long-term "high dose" of vitamin D3 safe? There may be concern that high doses of vitamin D may elevate serum calcium levels and cause kidney stones in those at risk. There was a study in which vitamin D deficient patients received either a single oral, or a single intramuscular injection of 300,000 IU of vitamin D and followed for 12 weeks. During the 12 weeks not one person had elevated levels of serum calcium (or hypercalcemia).

This doesn't mean that chronic super high doses of vitamin D will not raise blood calcium levels; however, there are no credible reports of vitamin D toxicity with chronic daily vitamin D3 supplementation up to 10,000 IU/day, including elevation of blood calcium. In fact, many vitamin D expert clinicians are routinely recommending doses well above 10,000 IU/day. Hypercalcemia (an elevated serum calcium level) is only observed with synthetic vitamin D analogues, such as calcitriol.

Since it is safe for most people to supplement with vitamin D with doses as high as 10,000 IU/day (and possibly higher) without concern, my recommendation of a starting dose between 4000 - 6000 IU/day is quite conservative.

Are there Contraindications for High-Dose Vitamin D?

Primary hyperparathyroidism is the main contraindication. Also, high dose vitamin D3 supplementation may cause elevation of serum calcium levels in patients with sarcoidosis, tuberculosis, or lymphoma. Therefore, in such cases, patients dosing with levels above 2000 IU per day should do so only with caution AND under the care and direction of a physician.

One Last Word: Maintain Proper Ratios and Balance of Vitamins

Vitamin D3 is obviously safe. It has been underestimated as an important vitamin for many decades for maintaining optimal health at least, and possibly for reducing the risk of many chronic diseases if boosted to optimal blood levels. However, as will all vitamins, minerals, antioxidants, essential fatty acids, or any other nutrient, vitamin D should be taken in balance! All nutrients should be used to supplement a healthy diet, and used in conjunction with exercise and a healthy lifestyle.

Balance and proper ratios of nutrients are critical, as in the case of vitamin D with vitamin A. Vitamin A can neutralize the beneficial effects of vitamin D. In addition, many people are aware that high doses of vitamin A can be toxic to the liver and cause birth defects. However, most are not aware that vitamin A and vitamin D compete for each other's function in the body. Supplementing with excess amounts of vitamin A can suppress the important cancer-fighting effects of vitamin D.

Most multivitamin preparations contain vit A. Vitamin A (or pre-formed vitamin A) is different from pro-vitamin A, or beta-carotene. Beta-carotene does not interfere with vitamin D. Nor is beta-carotene associated with birth defects or liver problems.

Therefore, in choosing a quality, broad spectrum supplement brand, it is my suggestion to choose one that provides beta-carotene (a.k.a. "pro-vitamin A"), not vitamin A. This is just one of many criteria in choosing a quality supplement brand. As it relates to this article, choose a supplement that provides a daily dose of vitamin D3 of at least 2000 IU/day,...and consider taking at least 4000 IU/day and having your blood tested to achieve the target range of 50 - 80 ng/ml.

We should never rely on one vitamin, juice, or magic potion to cure all our problems. However, we should not ignore the ever-emerging evidence and promise that science is uncovering of the benefits nature has to offer in helping us to maintain optimal health.

I am a major proponent of using a broad spectrum of high quality vitamins, minerals, antioxidants, and essential fatty acids at proper doses and balance, along with healthy eating and proper lifestyle. I do not claim that all the answers are found in one vitamin or antioxidant, but many of the answers to optimal health are found in the synergistic action of the blend and balance of the fullest range of supplementation we are willing to incorporate into our lives.

Stretch marks are white or red colored parallel fine lines that are formed on the thighs, hips, breast arms, etc. Medically they are known as striae. They are formed due to over stretching of the skin. Pregnancy and striae go hand in hand. But with some simple precautions and home remedies you can avoid or at least minimize these unwanted lines on your body. Here are some tips to get rid of the postpartum stretch marks.

How to treat & prevent postpartum stretch marks naturally?

· Massage: It is utmost helpful in preventing stretch marks. Actually these marks occur when the skin is expanded beyond its elasticity. Gently rubbing the vulnerable areas with natural elements that compensate the lost collagen (natural protein that forms new skin tissues) makes our skin more elastic. This reduces the chances of having these red colored wrinkles on your belly or the breasts.

For the massage you can apply one among the items given below:

- Olive Oil

- Almond Oil

- Vitamin E

- Aloe Vera Gel

- Cocoa Butter

- Shea Butter

- Wheat Germ Oil

- Jojoba Extracts

· Stay hydrated: You must have at least 8 to 10 glasses of water every day. This would keep the body hydrated and maintain the smoothness of the skin.

· Bathe with hot water: It opens the pores of the skin and allows it to breath. It helps in avoiding many other health issues as well.

· Castor oil: Apply a thick layer of castor oil on the areas like upper arms, buttocks, lower belly, etc. and cover it with a plastic sheet. Now mildly heat it with hot water bottle or a heating pad for 25 to 45 minutes. It allows the oil to seep into the skin and develop the necessary collagen and elastin.

· Eat a balanced diet: Have diet that is rich in zinc, vitamin A, C & E, proteins etc. It would help the body repair the damaged skin tissue and form new ones.

· Use stretch mark creams: You may choose to massage the required areas with one of the most effective anti stretch marks cream called Captiva. It comprise of all the above mentioned ingredients and some patented peptides. If this ointment is used regularly for the nine months of pregnancy, you would surely have little or no stretch marks. Captiva is also effective in removing the postpartum stretch marks.

In 2010 parents face many issues and obstacles that can lead to an unsettled baby. Any parent caring for an unsettled baby who will not sleep or feed properly will understand how distressing and exhausting both physically and emotionally this can be. I would like to briefly outline some of the areas that could be causing unsettled behaviour in a baby which may shed some light on what parents could do to help. I will break this into four age groups for easy reading:

0 - 4 months

• Maternal anxiety and emotional challenges which could lead to maternal postnatal depression. This fragile emotional state is reflected in a baby's behaviour.
- readjusting to home life after leaving employment
- isolation from a partner working away or no extended family support
- confusion from the abundance of 'helpful' advice
- relationship breakdown with the added pressure of a baby
- over conscientious personality with a high needs baby
• Overstimulated baby
- too many visitors
- too many outings
- bright lights
- shopping centres (some personalities more than others)
• Personality mix of a mother and her baby (Dr Sears)
• Intolerance
- wrong formula
- maternal diet imbalance if breast feeding (commonly high sugar or dairy intake)
• Colic or reflux pain and discomfort
• Digestive disturbances from spinal subluxations occurring at birth (Paediatric trained Chiropractor can assist with relieving this)
• Hungry
• Over fed
• Not ready to self settle and sleep

4 - 9 months

• Food intolerance and imbalance in a baby's diet
• Preservatives
• Increase in carbohydrates to protein and fats ratio
• Hungry requiring either more milk feeds or solids
• Overtired, rushed or overstimulated (media imaging)
• Recovering from or suffering from an illness
• Situation
-returning from holidays
-moving house
-dad works away
-too many trips in and out of the car, drop offs and carers
• 'sleep associations' that do not suit individual child or situation
-dummy
-feeding
-rocking
• Lack of suitable and consistent routine

9 - 18 months

• All of the above age group suggestions
• Parents trying too hard to get things right or comparing their baby to others without recognising individual development. This can lead to maternal anxiety, tension and depression
• A baby not having enough activity and stimulation to adequately prepare them for sleep

18 months onward

• Fears developing from what is seen or heard in books, media and situations witnessed or experienced at Day Care
• Night terrors occurring in the earlier part of the night
• Nightmares occurring in the earlier hours of the morning
• Lack of consistent and predictable routine
• Poor diet

Not all sleep issues or babies are the same, therefore different strategies maybe required. Some of these a parent will be able to fix themselves while others may require professional help.

Caring for your newborn might be your first concern after giving birth, but you should also learn to take care of yourself. As a mother who just gave birth, you have a number of challenges to face - physical, psychological, and wellness hurdles that Malay massage can help you overcome.

Physiological Postnatal Care

Even before you were pregnant you always took care of your body and your physique - and this task is more significant now that your body just underwent one of life's most perilous and strenuous processes. You could be experiencing aches, pains, and tumultuous internal changes caused by lingering hormonal imbalances.

Malay massage is a traditional eastern massage reserved for postnatal care, where it is used in conjunction with other traditional practices such as postnatal wraps. It effectively soothes sores and helps the body relax and heal itself - and used alongside oils, herbs, and other wellness tools, you can be certain your physiological postnatal care basics are covered.

Postnatal Stress Relief

Aches, sores, and pains are not the only discomfort you will experience after giving birth, however. Your still raging hormones will lead you to become more easily stressed as you are more easily tired in your current state. This stress can accumulate with devastating results, such as postnatal depression.

The art of Malay massage - being a holistic wellness practice - helps reduce stress levels within the body. Better yet, as its traditional roots are tailor suited for postnatal care, it can potentially work better than other wellness massage therapies.

Psychological Postnatal Care

After taking care of your body's pains and you're the stress your mind is under, there is one more item in the itinerary that most new mothers are greatly concerned over: getting back in shape. Being a mother does not entail being less beautiful or confident than you once were, and most mothers are challenged with the task of getting their figures back after childbirth.

The core function of traditional Malay massage along with the many other traditional implements that accompany it is to prepare for postnatal fitness, with one focus being the re-acquisition of a mother's "pre-baby" figure. It is one of few massages designed specifically with this endeavor in mind.

Birthing a child into the world is a rewarding experience, but it is also a very strenuous process that has long- lasting effects. Caring for the mother as a woman is important after birth, when bodily changes from within and without cause great discomfort and stress.

One of the biggest medical care cost events is maternity coverage, for the medical costs incurred during this period are already high and can vary depending upon the needs of the mother and the unborn baby. Insurance companies often put limits and restrictions on just what they will cover under maternity insurance coverage. The maternity period covers prenatal care and postnatal care for both mother and baby. Once the baby is born, he or she is placed under the typical health insurance coverage the family carries.

This coverage is important to have because not only will it help pay some of the expensive medical costs associated with having a baby, but it will also guarantee a high quality level of medical care. It is a well known fact that there are levels of care in the health care industry and those with quality insurance and ability to pay out of pocket expenses will be able to afford top notch health care services. This coverage ensures the needs of the mother and baby will be met and optimal care will be provided.

It is important to check the insurance policy's maternity coverage before pregnancy in order to be sure the coverage is present. If it is not, there are a few ways to get maternity coverage but most of them are in the form of expensive add ons or riders to the health insurance policy. Check the policy's maternity coverage before it is needed just in case there is a waiting period or added restrictions that could affect the amount of medical maternity coverage the policy will provide. Even with the added expense, it is beneficial to have maternity coverage on the health insurance policy.

Health insurance coverage for families is a very important part of protecting the family. Quality health insurance will ensure that families get top notch medical care and will safeguard the family finances from being drained to pay for medical care costs. This coverage is important to ensure the best possible medical care with many options is available to the expectant mother and the unborn baby. The overall cost of having a baby is expensive and there will still be significant out of pocket expenses to pay, but maternity coverage will offset a big portion of those costs. With good health insurance maternity coverage, quality care and affordable medical bills can bring peace of mind and the occasion can be enjoyed instead of worried over.

If you need assistance locating these types of special coverages, please visit our website at http://www.health-insurance-buyer.com and provide your contact information so we can respond to your request and help.