Guide For Caregivers
One out of five Americans over the age
of 80 will have symptoms consistent with dementia.
Alzheimer's disease is the most common form of dementia.
It is a progressive, degenerative disease of the brain.
Profound changes in personality and mental functioning
are not unusual.
Signs of dementia can vary from one person
to another. They frequently include:
- Increased levels of forgetfulness.
- Inability to carry out simple tasks.
- Difficulty in remembering words or in forming
coherent sentences.
- Confusion, hallucinations or paranoia.
If dementia is suspected, it is important to consult
a physician as soon as possible. Sometimes the effects
of medications, strokes, depression, vitamin deficiencies,
thyroid disease and other conditions can mimic dementia.
When this is the case, the problem can be controlled,
improved and even corrected. If this is not the case,
Alzheimer's disease is more likely the diagnosis. It
is important to point out that Alzheimer's disease
is not reversible. However, early diagnosis is key
because the progression of the disease can often be
slowed and the symptoms can be managed. Early detection
also allows time for everyone to plan ahead.
The most important thing to remember about irreversible
dementias is that they are manageable. Many symptoms
can be ameliorated. Often, an individual's functional
level and quality of life can be maintained or even
improved. Besides specific medication and herbal supplements,
there are several general treatments that can apply
to any irreversible dementia.
Managing Dementia
Ensure safety:
An identification bracelet that notes the patient's
condition can be helpful for those who wander away from
home. Devices like Lifeline serve to protect the patient
at home in case of an emergency. It may be necessary
to disconnect the kitchen stove to prevent fires or to
lower the temperature of the water heater to prevent
scalding. In some cases, a home assessment can be particularly
valuable to identify risks and implement changes. Those
with deteriorating Alzheimer's disease may no longer
be able to live at home without constant supervision.
Optimize function:
Keep the patient as mentally and physically active
as possible within his or her limits. There is growing
scientific evidence that much of the disability associated
with severely ill patients stems from disuse rather
than from neurologic defects of the disease itself.
Patients should be encouraged to take daily walks
with a caregiver or engage in other forms of physical
exercise.
Offer stimulation:
Mental stimulation should be tailored to the patient's
interest and ability. Mildly affected patients might
try writing, perhaps reading a paragraph in the newspaper
and writing what they remember, keeping a journal
of the day's events or recording stories from the
past. For those who have difficulty with writing,
the same exercises can be done orally. Likewise,
simple versions of previously enjoyed hobbies may
be available. A patient who can no longer read may
still enjoy looking at pictures. Other options include
adult day care, in-home services or senior community
programs. These provide caregivers with much-needed
respite and offer potential benefits to patients.
Maintain adequate nutrition:
Mildly affected patients who are living on their own
are at particular risk. They may have trouble choosing
the appropriate foods when shopping, preparing food
or remembering to eat.
These patients require someone to look in regularly
to ensure that they have appropriate food in the house
and are eating properly. Severely ill patients cannot
feed themselves and many eventually have difficulty
swallowing. A pureed or liquid diet may help, especially
if taken through a straw. The patient's and family's
wishes regarding feeding tubes should be discussed
as early in the disease course as possible.
Stay alert for other medical
illnesses:
An acute decline in cognition is often associated with
delirium syndrome, which can be due to infection, electrolyte
imbalance, drugs, tumors, trauma and decompensation
or exacerbation of chronic disease states. Individuals
with preexisting dementia are at the greatest risk
for delirium. Any sudden mental decline or new disruptive
behavior should prompt a careful medical evaluation.
In addition, medications should be kept to a minimum
because of side effects.
Use proactive planning: As
soon as a dementia diagnosis is made, the patient and
family should be directed to consider the future. Wills
should be in order, financial planning should take
place, power of attorney should be completed, advance
directives (living will or health care proxies) should
be executed. Consideration should be given to future
caregiving needs. Families may even visit nursing facilities
and place the patient on a waiting list. The need to
do this early is mandated by the progressive nature
of dementia and the desire to have the patient participate
in decisions. Even moderately demented patients may
still have decision specific capacity.
Maintain caregiver well being:
An Alzheimer caregiver devotes a significant amount
of her time and energy to the patient. The caregiver
is likely to experience great stress and show signs
of burnout. Often, the caregiver is reluctant to
share these burdens with others because of the perceived
stigma attached with dementia. Also, demented patients
often look well and hence fail to elicit natural
sympathy from friends and family who do not live
with the patient. There are many strategies to help
the caregivers. The single most important step is
referral to the local Alzheimer's Association (AA)
chapter. Through AA, caregivers can join support
groups and obtain referrals to community resources.
Another important way to help the caregivers is to
encourage respite care. Take care of yourself. A
sick caregiver is not a good caregiver.
Despite Alzheimer's bleak prognosis, a caregiver can
do a great deal to ease the way for a loved one who
has the disease. After all, a person with Alzheimer's
disease can still function and enjoy life for a time,
even as mental faculties gradually decline.
Saint Barnabas Medical Center offers a new service
called Geriatric Assessment Program (GAP) that can
help families address these problems. The GAP team
includes a board-certified Geriatrician, a Gerontological
Nurse Practitioner and a Social Worker, all trained
in the care of older adults. GAP offers consultative
outpatient evaluations designed to assist older persons,
their families and their primary care physicians in
addressing special health care needs and providing
optimal individualized solutions for conditions like
Alzheimer's disease.
To learn more, please call 973-322-7988.
Check out the online guide of the U.S. Administrator
on Aging at http://www.AOA.gov/wecare.
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Catch
A Rising Star in the James L. Breen, M.D., Obstetrical
Pavilion at Saint Barnabas
Parents of babies born at Saint Barnabas are invited
to celebrate the birth of their little one by placing
a star, personalized with baby's name and birthdate,
on a new "A Star is Born" Wall on the James L. Breen
M.D., Obstetrical Pavilion. All proceeds benefit the
special amenities provided to new moms, such as unique
dinners for new parents, the televised Newborn Channel
on baby care and postpartum topics, the specialized
Women's Resource Library and "info buggy."
What is the "A Star is Born" Wall?
The Saint Barnabas Medical Center "A Star is Born" Wall
is a display on the James L. Breen M.D., Obstetrical
Pavilion that celebrates the births of babies born
at Saint Barnabas and recognizes the families' financial
support of the Medical Center. Proud families may place
star-shaped plaques, personalized with babies' celebrate
the births of their, and our, "shining stars."
Stars may be reserved by the parents, grandparents,
friends and loved ones of any child born at Saint Barnabas
Medical Center at any time. The star-shaped plaques
are brass in color and are engraved with babies' names
and birthdates.
Stars are available in four sizes:
- Super Stars: $2,500
May list up to three names, depending on name length
- Large Stars: $1,000
May list one or two child(ren)'s names and birthdate(s)
depending on name length
- Medium Stars: $500
May list one or two child(ren)'s name and birthdate(s)
depending on name length
- Small stars: $250
May list one child's name and birthdate
For more information about the "A Star
is Born" Wall, or about further supporting Maternal
Child Services at Saint Barnabas Medical Center, please
contact the Saint Barnabas Medical Center Foundation
at (973) 322-4338.
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The
James L. Breen, M.D., Obstetrical Pavilion Announced
At a black-tie tribute dinner held in
December at The Hilton at Short Hills, Ronald J. Del
Mauro, President and Chief Executive Officer of the
Saint Barnabas Health Care System and Chairman of Saint
Barnabas Medical Center, publicly announced plans to
rename the Medical Center's maternity service, The
James L. Breen, M.D. Obstetrical Pavilion. This dedication
is made possible by the many contributions of Dr. Breen's
colleagues, former residents and friends in recognition
of the profound impact he has made in the lives of
countless women and children.
The James L. Breen, M.D. Obstetrical
Pavilion honors Dr. Breen's distinguished tenure at
Saint Barnabas and his role in building one of the
nation's leading obstetrics and gynecology departments.
Dr. Breen has been chairman of the Ob/Gyn Department
at Saint Barnabas since 1969 and has trained more than
one hundred residents.
Located primarily on the third floor
of the Medical Center, the Breen Pavilion will be a "hospital
within a hospital" dedicated to the care of mothers
and babies. An elegant lobby will serve as the gateway
to the third floor's Antepartum Care Unit, the Perinatal
Evaluation and Treatment Area, the Labor and Delivery
Unit, the Neonatal Intensive Care Unit, two postpartum
Mother Baby Units and a premier Mother Baby Unit to
be built on the sixth floor. The lobby is currently
under renovation and will be completed this summer.
Construction on the new unit, which will feature private
patient rooms, will begin shortly.
In grateful recognition of his legacy
of caring, Saint Barnabas Medical Center, is proud
to recognize Dr. Breen through the dedication of The
James L. Breen, M.D. Obstetrical Pavilion.
[ top ]
The
Benefits of Flaxseed
"Improve nutrition. . . decrease risk
for cancer and heart disease. . . gain health benefits
including improved immune function and relief of constipation."
Such claims are often made regarding
functional foods. Functional foods are the leading
trend in the food industry today and have the potential
to make a significant impact on your health. One of
those foods that can live up to these powerful claims
is flaxseed.
What is flaxseed?
Flaxseed is a small, flat, reddish brown seed with
a mild, nutty flavor.
Flaxseed is:
- Low in saturated fat
- High in polyunsaturated fat
- High in omega-3 fatty acids
- High in soluble fiber
- High in protein
- High in lignans (a type of plant phytoestrogen)
What are the benefits of adding
flaxseed to my diet?
Because of its nutrient profile, incorporating flaxseed
into your diet can have many health benefits. These
include a decreased risk of heart disease, inflammatory
and autioimmune disorders, arthritis, high blood pressure
and some cancers.
How does it help lower the risk
for these conditions?
Studies show that omega-3 fatty acids and soluble fiber,
which are both found in flaxseed, contribute to decreased
cholesterol (LDL), triglycerides, blood pressure and
platelet aggregation. These are all risk factors for
cardiovascular disease. The lignan part of flaxseed
is a type of plant phytoestrogen that has been credited
with having anticancer properties. Lignans work by
interfering with the negative effects of estrogen,
in addition to blocking tumor formation. This can be
especially beneficial in protection against hormone-sensitive
cancers such as breast, prostate and endometrium.
Where do I get flaxseed and how
much do I take?
Flaxseed can be purchased at health food stores
and some supermarkets. Whole flaxseed, ground or milled
flaxseed and flaxseed oil are available. Ground flaxseed
provides the most nutritional benefit. Whole flaxseeds
often remain unbroken and pass undigested through the
body, reducing the nutritional advantage. Flaxseed oil
should contain "added lignans," as the fiber and lignan
component is usually destroyed when processed into oil.
Whole flaxseed can be ground at home with a coffee grinder,
food processor or blender. The recommended dose is 1-2
tablespoons per day.
How do I use flaxseed?
Ground flaxseed can be sprinkled on:
- yogurt
- cereal
- salads
- soups
- casseroles
Flaxseed oil can be added to salads or dishes after
cooking. Cooking with oil destroys the omega-3 fatty
acids. For baking purposes, ground flaxseed can be
substituted for the fat in baking at a ratio of 3
to 1. For example, 1 1/2 cups of ground flaxseed
can replace 1/2 cup butter, margarine or oil.
How do I store flaxseed?
Whole flaxseed can be stored up to one year at room
temperature. Once flaxseed is ground, it should be
refrigerated in an airtight, opaque container and
used within 30 days. Ground flaxseed can be frozen
for up to six months.
Where can I find more information
on flaxseed?
On the internet at www.flaxcouncil.ca.
[ top ]
The Pap Test
During WWII a Greek physician, George
Papanicolaou, discovered a way to identify abnormalities
in the cells of the cervix. In the normal course of
life, these cells exfoliate (peel off) from the surface
of a woman's cervix. This evaluation, which became
known as the "Pap Test," has revolutionized women's
health care. It has decreased the incidence of cervical
cancer, changing it from a major killer of women worldwide
to a minor player in that same theatre.
Most American women understand that they
should go to the gynecologist for a Pap smear on an
annual basis, but few truly recognize the significance
of this test, its results and their management.
Taking a Pap Test
A physician evaluating cells from a patient's Pap smear
is much like a person who picks up some leaves from
the floor of the woods and attempts to understand
the nature and health of the trees. This is to say
that the Pap smear is a test and only a test. It
does not provide a diagnosis, but simply gives the
physician or other health care provider a strong
indication that he or she must search for the source
of cervical abnormalities if they are found.
The Pap test is performed by the physician
who obtains a sample of the entire surface of the cervix
with a spatula. A cytobrush is then inserted into the
endocervix, rotated and then removed. The material
is then placed on a slide, sprayed with fixation to
avoid drying and then sent to a laboratory for evaluation.
There is also a Pap test called "The Thin Prep," which
was invented recently. This Pap test requires the physician
to collect the cervical cells in the same manner he
or she would a regular Pap test, but the cells are
preserved in a different manner. Once the cells are
collected, the physician rinses them in a vial of liquid
instead of placing them on a slide. This allows the
physician to preserve most of the cells obtained, and
avoids clumping of the cells, which can occur with
the slide. This vial is then sent to a laboratory,
where it is evaluated.
Pap Test Results
Pap test reports today are returned to physicians'
offices with a description of the abnormal cells.
The older classification using Roman Numerals I-V
has been discontinued. The Bethesda Reporting System
is now being used by most laboratories in reporting
Pap smears. Based upon this description of the cervical
cells found in the exfoliate cytology specimen, your
gynecologist can then make recommendations for possible
further evaluation and treatment. Most patients'
Pap smears are read as normal. However, for a Pap
smear to be really considered completely normal it
must contain cells from the inside of the cervix
(endocervical cells). Therefore, it is not uncommon
to hear from your physician or nurse that although
the Pap smear was "normal," the sought-after endocervical
cells were not identified. In this situation, the
Pap smear needs to be repeated in order to make sure
that the sample came from the most appropriate place
in your cervix.
Another common but not dangerous abnormality
reported in Pap smears is inflammation, inflammatory
atypia, or what is described as atypical squamous cells
of undetermined significance (ASCUS). When a gynecologist
is faced with a report of this nature, it is sometimes
necessary to both treat a possible bacterial infection
with a cream and reexamine the patient's cervix, or
perform a microscopic examination of the cervix in
the physician's office.
The microscopic examination is known
as a colposcopy. Physicians, using this large, welllighted,
magnifying glass and several different colored stains,
can seek to identify areas of abnormal cells on the
cervix and perform biopsies. Although this sounds like
an extremely uncomfortable procedure, the cervix does
not have a nerve supply that identifies the sensation
of the biopsy instrument. Therefore, most patients
have little or no little pain when the cervical biopsies
are taken. The physician then interprets these biopsies
and recommendations are made for further follow-up
or care.
Pap Test and Cancer
Notice that throughout this entire article, we have
not mentioned the identification of cervical cancer.
This is because, thanks to the early diagnosis of
the precancerous cervical abnormalities known as
dysplasias, and the treatment of these problems either
in the office or in the outpatient surgery center
by more extensive cervical biopsies, the incidence
of invasive cervical cancer has been reduced to the
lowest that it has been in the last 50 years.
Women can protect their health and preserve
reproductive integrity best by following a routine
of annual gynecological visits and Pap smears in accordance
with their gynecologist's recommendations. The telephone
call from the gynecologist indicating that an "abnormality" has
been found need not, and should not, strike fear into
the hearts of patients. Usually, these abnormalities
are of a very mild nature, and when attended to in
a timely manner, result in continued gynecologic health.
Most certainly the responsibility of adhering to the
physician's recommendations for follow-up evaluation
visits becomes the keystone of the protection and preservation
of well being.
[ top ]
Maternal
Child Health Indicators Bulletin
The good news about the latest national
perinatal indicators is that more women are receiving
prenatal care and fewer women are smoking during pregnancy.
The bad news is that there are more pre-term births,
and low birthweight births.
Compared to the national average, New
Jersey has had fewer births to teens, about 8 percent
compared to 12 percent nationally. Access to prenatal
care during pregnancy, either late or not at all, was
between 4 percent and 5 percent; nationally that number
dropped to less than 4 percent.
Low birthweights continue to be a problem
in New Jersey. Since 1990, there has been a 13 percent
increase in low birthweight babies in the state. Women
who do not receive prenatal care have been associated
with poor pregnancy outcomes as well as low birthweight
births.
SMOKING AND PREGNANCY
One way to help ensure a healthy pregnancy is
to stop smoking. The American Lung Association (ALA)
reports that cigarette smoking during pregnancy can cause
serious health problems to an unborn child. Smoking during
pregnancy has been linked to premature labor, breathing
problems and fatal illness among infants. Smoking during
pregnancy accounts for an estimated 20 to 30 percent
of low birthweight babies, up to 14 percent of preterm
deliveries and some 10 percent of all infant deaths.
Maternal smoking has also been linked to asthma among
infants and young children.
Smokers inhale nicotine and carbon monoxide,
which reach the baby through the placenta and prevent
the fetus from getting needed nutrients and oxygen.
According to the ALA, secondhand smoke also adds a
risk to pregnancy. Breast milk often contains whatever
is in the woman's body. If the woman smokes, the baby
ingests the nicotine in her breast milk. The Center
for Health & Wellness at the Saint Barnabas Ambulatory
Care Center offers a course called Smokenders. This
course is the oldest, largest and most successful program
in the world and combines proven, educational meetings
once a week with group support, nutritional support
and behavioral management techniques. Since 1969, nearly
one million people have quit smoking with Smokenders.
The cost for the course is $180 per person. To register,
please call (973) 322-7444.
[ top ]
Diabetes
and Pregnancy
While being pregnant is exciting enough
for most women, some patients have the added burden
of having diabetes while pregnant. Although the diagnosis
of diabetes in pregnancy does not carry the same risk
that it did a mere 80 years ago (where a live baby
was considered a rarity), it still is a condition that
requires the utmost respect and effort from the mother
and her physician to optimize her chances of having
a healthy baby.
Two situations are frequently encountered
in obstetrics. About one in 200 pregnancies is complicated
by pre-existing diabetes mellitus. Many of these patients
have Type 1 or childhood onset diabetes and the other
half have Type II or non-insulin dependent diabetes.
The more common situation involves patientswho are
healthy before pregnancy but develop glucose intolerance
only during pregnancy. This is called gestational diabetes
and occurs in about 1-4% of all pregnancies.
Pre-Existing Diabetes
Management Pre-existing diabetes is an excellent example
of a condition that is best managed by starting with
a preconceptional consultation. This is a visit that
a patient makes with her caregiver prior to becoming
pregnant to assess her health and allow some conditions
to be treated or modified to allow the best chance
for a healthy baby and mother. Insulin dependent
diabetes increases the risk of a woman having a fetus
with a congenital birth defect by 2-3-fold. Studies
have clearly shown that if a woman can improve her
glucose control by diet, exercise and changes in
her insulin regimen, the chance that she will give
birth to a baby with a birth defect can be reduced
to about the same level as a patient without diabetes.
There are numerous aspects of the woman's
care that can be best evaluated prior to pregnancy.
Weight loss, laser treatment of visual problems, institution
of tighter glucose control and heart and kidney evaluations
are often carried out at this time and permit the ideal
opportunity to assess the maternal and fetal risks
involved in these complex pregnancies. These pregnancies
are at increased for multiple potential complications,
including birth defects, stillbirth, abnormally large
fetuses, operative delivery and preeclampsia or toxemia.
Thus, the prenatal care the mother receives is often
more involved than that of a healthier mother. Serial
ultrasound evaluations are usually performed throughout
the pregnancy to look for evidence of birth defects
and to ensure that fetal growth is normal. Fetal echocardiograms,
or specialized ultrasound evaluations of the fetal
heart, are carried out because of the increased risk
of heart defects in these babies.
Beginning at about 32 weeks' of pregnancy,
the mother is usually seen twice per week to allow
evaluation of the fetus. Antepartum testing, in the
form of ultrasound evaluations (biophysical profile)
or fetal heart rate tracings (nonstress tests), are
performed in the office setting. They allow the physician
to determine if the developing fetus appears to be
receiving enough oxygen and when the testing is normal,
the chance for the fetus to be stillborn is markedly
decreased. Patients are asked to be in frequent contact
with their physician during the pregnancy to allow
insulin adjustments to be made as needed. All of this
advanced care demands a great level of commitment from
the mother. However, with these modern standards, most
such cases result in the delivery of a healthy newborn
to a joyous mother.
Managing Gestational Diabetes
Gestational diabetes may be more common than pre-existing
diabetes but fortunately it is usually associated
with less risk to both the mother and the fetus.
At about the 24th-26th week of pregnancy, women drink
a glucosecontaining (sugar) drink and an hour later
their blood glucose level is checked. A small number
of women will have a level greater than normal and
they then repeat the test with four blood levels
being tested. If two or more levels are elevated,
the patient begins both a diet and home glucose monitoring.
The goal of the diet is to control glucose levels,
not to lose weight. Fortunately, testing after the
delivery usually shows that the elevated glucose
levels were only a problem during the pregnancy.
Although diabetes during pregnancy does
put an additional burden on the mother and her baby,
committed efforts by the patient, the perinatal team
and her physician now most often lead to the birth
of a healthy baby.
For an appointment with The Division
of Maternal-Fetal Medicine at Saint Barnabas Medical
Center, please call (973) 322-5287.
[ top ]
Relaxation
During Pregnancy
The Rehabilitation Center at The Saint Barnabas Ambulatory
Care Center, Outpatient Physical Therapy, (973) 322-7500
Relaxation is an important tool that
can be used not only during pregnancy and childbirth,
but also for life. Relaxation is the active concentration
on freeing the mind and body from tension. It enables
one to feel better by reducing the physical discomforts
of pregnancy and allows one to be more "in touch" with
her own body. These skills are important during labor
and delivery because tense muscles may impede progress
and may make labor and birth more difficult and painful.
How to begin:
1. Choose a quiet environment free from distraction.
2. Wear comfortable clothing.
3. Get into a well-supported body position, either
semi-sitting or
side-lying with body parts supported using pillows
as necessary.
4. Consciously ask your body to "let go," trying
to experience the
sensation of relaxed muscles as tension leaves each
body part.
5. Let your eyes close and feel them as heavy lidded.
Listen to the
sound of your own breathing and with each breath out,
actively relax
a little more.
[ top ]
Breastfeeding:
A to Z
At Saint Barnabas Medical Center, we
know that your breastfeeding education and experience
is very important. In keeping with that goal, all of
our Family Centered Care nurses have special training
in Lactation Education and are Lactation Specialists.
We have developed the following mission
statement, which supports our efforts and philosophy.
Breastfeeding Mission Statement
Saint Barnabas Medical Center supports
a philosophy of Family Centered Care and advocates
breastfeeding for all mothers. Research demonstrates
that breast milk is the preferred food for infants.
It is our goal to educate all mothers
about the health benefits derived from breastfeeding,
enabling them to make an informed feeding choice.
We believe successful breastfeeding is
accomplished by:
- Introducing the infant to the initial feeding
within the first hour after birth
- Feeding an infant on demand throughout the day
and night
- We believe that the continuum of breastfeeding
is dependent on
- Participation in prenatal, inpatient and postnatal
education
- Individual instruction by trained personnel
- Post discharge support through a telephone hotline
and breastfeeding support groups
It is the hope and belief of the Family
Centered Care Team that the results of a strong breastfeeding
support system will:
- Enhance the health of infants
- Increase the mother's confidence
- Provide a positive maternal/child experience
THE 10 Most Frequently Asked
Breastfeeding Questions
Q. When is the best time to initiate
breastfeeding?
A. Breastfeeding should be initiated
immediately after birth if you have a vaginal delivery.
If you have a cesarean section, breastfeeding should
begin in the recovery room. Whether you have a vaginal
or cesarean section, breastfeeding should be initiated
within the first four hours.
Q.How often should I breastfeed?
A. Breastfeeding should be done on demand.
That means that initially, if your infant want to eat
every 1 1/2 to 2 1/2 hours, that is what you should
do. Even if the baby doesn't demand frequent feedings,
you should feed the baby (in the beginning) every 2-3
hours, totaling 8 feedings per 24 hours.
Q.How long should I feed on each breast?
A. At least 10 minutes on each breast
in the beginning, working up to 20 minutes on each
breast.
Q.How many times a day should my baby
urinate?
A. Once your milk comes in, you should
see 6-8 wet diapers daily. Fewer wet diapers prior
to that it may be less due to low volume feedings.
Q.Should I wake my baby up to feed?
A. During the day YES, at least every
2-3 hours. During the night, let the infant sleep as
long as five hours without feeding, but no more than
that.
Q.How do I wake my baby?
A. Unwrap and stimulate your baby by
changing the diaper, washing baby's face and rubbing
feet.
Q.How much fluid should I drink while
breastfeeding?
A. Drink at least 8 oz of fluids (preferably
water) each time you breastfeed. Hydration is one of
the most important aspects of breastfeeding (please
note: contrary to some information that has been circulating,
increasing your fluid intake does not dilute your breast
milk). Increasing your fluid intake increases milk
production.
Q.What foods should I avoid while breastfeeding?
A. Any foods that were restricted or
forbidden during pregnancy should continue to be restricted
during breastfeeding. Limit amounts of caffeine, chocolate
and alcohol. Continue to take your prenatal vitamins.
Calcium intake should increase by 500mg daily.
Q.Is it necessary to pump while breastfeeding?
A. The only time it would be necessary
to pump is the following: you have an engagement and
will have a sitter for your infant, you are unable
to nurse for any reason (medications, for example),
or you are engorged. Prior to pumping (for any reason)
you should contact a lactation consultant, our breastfeeding
hotline or your physician.
Q.How long should I breastfeed?
A. This is a very personal decision and
you need to decide based on your own comfort level.
You need to know that however long your breastfeed,
you and your baby will benefit from this beautiful
maternal experience.
For All Moms:
We also want you to be aware that your breastfeeding
education and supportive experience do not end with
your discharge from Saint Barnabas Medical Center.
We continue our support with our Breastfeeding Support
Group which is held on the first four Tuesdays of
every month from 1- 2 p.m. Immediately following
is our Parenting Insights Group from 2 - 3 p.m. These
programs are free of charge and offered to anyone,
even if you did not give birth at Saint Barnabas
Medical Center. Please call 973) 322-2584 for more
information. Dads and babies are welcomed.
[ top ]
Saint
Barnabas' Maternal-Fetal Medicine Division Welcomes
New Perinatologists
Wendy Warren, M.D., and Dom A. Terrone.
M.D., are the newest members of the physician team
at the Division of Maternal-Fetal Medicine, part of
the Department of Obstetrics and Gynecology at Saint
Barnabas Medical Center, Livingston. The perinatologists
of the Division of Maternal-Fetal Medicine are experts
in the field of perinatal medicine and the treatment
of women who anticipate or are experiencing a high-risk
pregnancy.
Dr. Warren, an Associate Director with
the Division, joined the team in 1999. After receiving
a M.D. degree from Cornell University Medical College,
she completed a fellowship in maternal/fetal medicine
at Columbia University College of Physicians & Surgeons.
Dr. Warren was previously a staff perinatologist with
St. Joseph's Hospital and Medical Center, Paterson.
Dr. Terrone, who joined the Division
in 2000, graduated from the University of Medicine
and Dentistry of New Jersey. He received a master's
degree in maternal-fetal medicine from the University
of Mississippi, Jackson. Dr. Terrone completed an internship
and residency in obstetrics and gynecology at Saint
Barnabas. His fellowship in maternal-fetal medicine
was completed at the University of Mississippi Medical
Center.
Drs. Warren and Terrone join Leon G.
Smith, J.R., M.D., Director of the Division, and Associate
Directors Edward Wolf, M.D., and Richard Miller, M.D.
All of the perinatologists serve as consultants to
other obstetricians in the tri-state area in the management
of complicated and high-risk pregnancies. As members
of Saint Barnabas Medical Center's departmental faculty,
they are actively involved in teaching and research
in areas such as unique fetal therapies and pregnancies
with multiple fetuses.
For more information about the Division
of Maternal-Fetal Medicine, please call (973) 322-5287. |
