UVA Health System Blog

Stories about the patients, staff and services of UVA

 

Transient Ischemic Attack: Why You Should Worry (Podcast Tuesday)

On July 7, 2015 | At 9:07 am

They’re often called “mini-strokes,” but they’re not necessarily mini. A transient ischemic attack (TIA) is a serious warning sign that you could have a stroke in the next two days. Symptoms come on very suddenly and include:

  • Weakness
  • Numbness
  • Clumsiness
  • Loss of vision in one eye

If you or someone else is experiencing these symptoms, call 911 immediately.

Listen to neurologist Brad Worrall, MD, explain why doctors take TIA symptoms so seriously.

Filed under : Neurosciences,Podcast Tuesday | By
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Maternity Monday: Newborn FAQs

On July 6, 2015 | At 8:39 am

You’re home from the hospital with your newborn and finally settling into a routine.  But you have questions, lots of questions that never popped into your head until this tiny person was in your arms.

preconception, pregnancy and childbirth

Join us as we journey through preconception, pregnancy, childbirth and beyond in a series we call Maternity Monday.

Lisa Hainstock, MD, wants parents to understand that no question or concern is too insignificant for your pediatrician.

We asked Hainstock some of the most common questions she gets from new parents.

When should parents call the doctor?

If there are concerns, parents should have no hesitation about calling the pediatrician.

Otherwise, call if the baby:

  • Has a fever of 100.4 or higher
  • Is excessively fussy or lethargic
  • Isn’t feeding well
  • Has a decrease in wet diapers

What is a normal feeding schedule like?

There is no normal feeding schedule. I tell parents to aim for eight to 12 feedings a day. But a lot of parents think their baby should feed every three hours. Many parents think their baby should feed every three hours by a clock, but more often than not, they are on their own schedule.

If the parent is waking the baby up to eat by a schedule, it may result in a poor feeding, and both will be unhappy.

How do you know if the baby’s eating enough?

lisa hainstock, charlottesville and crozet pediatrician

Lisa Hainstock, MD

In the first week of life, we go by this rule: The number of wet diapers should equal the number of days of life. So 3-day-old babies should have three wet diapers in 24 hours. During those first days, the baby is learning to eat. It also takes some time for the mother’s milk to come in if she is breastfeeding.

After the first week, the baby should have seven or more wet diapers a day. That’s a good indicator the baby is well hydrated.

What’s a typical weight loss after birth? When will the baby start gaining weight?

We don’t want to see the weight drop by more than 10 percent. Three to 10 percent is typical. If the baby has excessive weight loss, we may need to look at other feeding strategies.

Most babies are back to their birth weight by 10 to 14 days of life. Some signs and symptoms are considered emergencies, including:

  • Green vomit
  • Excessive vomiting
  • A firm and distended abdomen

Parents should call the pediatrician right away if they notice any of these, as it may indicate a surgical emergency. A blockage of the intestines is rare but important to recognize early.

Why is the baby spitting up so much?

100 percent of babies have reflux. The area between the stomach and the esophagus isn’t strong enough to keep the food in when they’re newborns. This often resolves by six months to a year.

As long as the baby is gaining weight, it’s not typically concerning. If you think it’s excessive, you should discuss it with your pediatrician.

How often should the baby be pooping?

It really varies. Some poop eight to 10 times a day; some only every other day. As long as they’re eating and gaining weight, don’t focus on the number.

What about poop color? Is it important?

Don’t worry about the poop color unless it’s overtly white or has blood or mucus. All shades of green, brown and yellow are normal.

Should we be concerned about this rash?

There are so many infant rashes, and the vast majority of them are benign. Parents shouldn’t hesitate to call the pediatrician if they’re concerned. Definitely call if the rash is tender, associated with a fever or excessive fussiness, or there are fluid-filled blisters.

when to call the pediatrician

Don’t be afraid to call the pediatrician if you’re worried about your baby.

With diaper rash:

  • Use an ointment with zinc.
  • Keep the baby’s diaper off if possible.
  • Limit using soaps and wipes with perfume. If the rash is especially bad, use warm water and a soft cloth instead of wipes.
  • Stay on top of diaper changes — check every two hours if the baby is awake.

The baby bumped her head. Is this serious?

It’s worthwhile to call the pediatrician for any fall involving a head bonk or injury. The pediatrician will likely want to know the method of injury and how the child is behaving. A fall from sitting on the carpet is probably OK, whereas a fall from a bed onto a hardwood floor could result in a more serious injury

We get concerned if the baby lost consciousness, is vomiting or is excessively fussy or sleepy.

If the baby’s crying for no obvious reason, how long should we wait before getting concerned?

If your baby is crying and inconsolable for a long period of time, call the pediatrician. It could be something benign like colic or reflux, but it may represent something more serious, such as an infection.

How do we take care of and clean the umbilical cord area?

Less is more in taking care of the umbilical cord.  We do not recommend alcohol wipes to the area anymore. Keep the area as dry as possible. Only give sponge baths until the cord falls off.  After that, it’s fine to give the baby a regular bath.

How should we dress the baby? Should she be warm or cooler?

The best advice I can give is to dress the baby the way you are dressed. If you are comfortable, the baby likely is as well.

Find a Pediatrician

By Your Side Pediatrics, where Hainstock works, makes home visits!

Or look for a pediatrician near you.

 
 

Babies, Neurological Discoveries and More: June 2015 Roundup

On July 3, 2015 | At 10:25 am

School’s out for the summer! Are you ready for more time with the kids? Learn some fun summer activities to do with your family in a parent’s summer survival guide.

The Battle Building celebrated its one-year anniversary! It will continue to provide pediatric primary and specialty care for years to come. Take a virtual tour of our most colorful building.

Our Maternity Monday series is coming to a close. Check out our latest postpartum posts and look forward to our finale on Monday, July 6th.

fun exercise infographic

View full size – summer activities for the family

Like our Virginia weather, our weekly podcasts have been heating up:

UVA In the News

Some of our stories made the news:

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Podcast Tuesday: Is It a Cold or Allergies? [AUDIO]

On June 30, 2015 | At 9:41 am

Chances are, if you don’t have a runny nose right now, you’ve had one recently. But it can be tough to tell whether you have a cold or seasonal allergies.

Do you have allergies?

Find an allergy clinic near you.

In this week’s podcast, Monica Lawrence, MD, who specializes in seasonal allergies, explains:

  • The difference between cold and allergy symptoms
  • Different over-the-counter allergy medications
  • How to avoid nasal spray overuse
  • How nasal irrigation methods like a Neti pot can help

 
 

Maternity Monday: Sleep Schedules for Moms and Babies

On June 29, 2015 | At 10:37 am

Giving birth puts your body through a lot of trauma, and the baby has gone through an ordeal as well. Your body needs to relax! It may go without saying, but don’t make big plans in the days and weeks following baby’s arrival. Sleep is a priority! Visitors may come and go, but it’s OK to tell people it’s time to relax and ask them to come back another time.

Mommy and Baby Need Sleep

The new baby needs a lot of sleep, anywhere between 16 to 20 hours per day, says pediatrician Heather Quillian, MD. The baby’s sleep schedule will be disjointed and erratic, and you may not be able to predict when the baby will sleep. Your baby will only be comfortably awake for an hour or two at a time.

preconception, pregnancy and childbirth

Join us as we journey through preconception, pregnancy, childbirth and beyond in a series we call Maternity Monday.

Baby will let you know when they are sleepy. Watch for certain signs:

  • Yawning
  • Rubbing eyes
  • Fussing
  • Acting fidgety

Don’t be alarmed if baby sleeps for more than a few hours at a time, but remember your baby will need to eat every several hours, Quillian says, don’t allow or expect your new baby to sleep a full nights sleep (8 hours or more). If this is the baby’s sleeping habit, consult your pediatrician.

Mommy needs sleep, too. Doctors recommend lying down and resting every time baby sleeps, even if you don’t fall asleep. Your body has gone through a lot and needs time to recover. Pregnancy prepares you for a lack of sleep, Quillian points out. It’s rare to sleep through the night at nine months pregnant, and in the first months of baby’s life, mommy and daddy shouldn’t expect a full night’s sleep either.

Getting on a Sleep Schedule

Quillian admits it’s hard to get baby on a sleep schedule until about four months of age. A new baby doesn’t really understand the concept of daytime and nighttime, just that they feel tired and want to sleep. Don’t try to keep baby awake through the daylight hours to ensure they sleep longer at night. It won’t work and you will likely have a fussy baby.

A baby's crib or bassinet should have absolutely nothing in it. "Make it boring," says Dr. Quillian

A baby’s crib or bassinet should have absolutely nothing in it. “Make it boring,” says Dr. Quillian

During the early days and weeks, be sure to cuddle and snuggle your baby as much as you can. “There is no such thing as too much spoiling,” says Quillian. Baby loves to be held and needs the human interaction. The snuggling will help baby feel comforted and will promote sleep.

Baby may sleep as long as four hours at a time, but it may not be at night. It’s easier to adjust our schedule than to try to adjust theirs.

If you try to implement a sleep schedule too early, you may feel like you’re spinning your wheels, and, in fact, even at four months old, baby may not catch on. After a few months though, you can start a routine that implies to baby that it’s nighttime and time to sleep:

  • Keep your household at a manageable noise level during the day and quieter at night.
  • Turn the lights down low at nighttime.
  • Change baby into pajamas.

Remember, sleep promotes sleep, and babies may not learn how to sleep on a schedule if left to do their own thing. Do not leave them to their own devices, Quillian warns. With help from parents they will learn slowly over time that nighttime is sleep time. Getting a baby into a good sleep pattern can take some work, but it is worth it, Quillian advises. A good night’s sleep benefits everyone.

SIDS, Sleep and Safety

There is plenty of information out there regarding baby sleep safety and sudden infant death syndrome (SIDS) prevention. “Make sure there is a firm sleep surface; that’s the most important thing,” says Quillian. “A crib or bassinet will do. There should be nothing in it. No blankets, no pillows.”

Quillian adds that baby should be laid on his or her back, and pediatricians at UVA do not recommend any sleep positioners. It’s okay, she adds, to be swaddled in a light blanket or sleep sack, but keep the crib as boring as possible. All the things that make your bed cozy are an absolute no-no for your baby.

Having a new baby at home will be intimidating, and you may be worried about baby sleeping too much or too little. If you have any concerns, be sure to call your pediatrician.

 
 

Podcast Tuesday: Recovering from a Heart Attack [AUDIO]

On June 23, 2015 | At 9:29 am

In the past, anyone who survived a heart attack would have to take three weeks to recover in bed. Now, patients are usually able to get up after two days and can leave the hospital a day or two later. But that doesn’t mean they’re 100 percent recovered.

Listen to cardiologist Ellen Keeley, MD, explain how UVA helps heart attack patients after they leave the hospital, helping patients make diet and lifestyle changes.

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Maternity Monday: The Reality of Postpartum Depression

On June 22, 2015 | At 10:43 am

Having a baby: It’s a delight, it’s a joy — and it is also stressful. No matter how positive the birth experience, how well-prepared you are as a parent (you read every Maternity Monday post, for instance!) and no matter how pleasantly your infant integrates into the world, the arrival of a whole new person into your family shifts the very fundamental makeup of life as you know it.

Which is why postpartum depression (PPD) happens to a lot of new mothers.

preconception, pregnancy and childbirth

Join us as we journey through preconception, pregnancy, childbirth and beyond in a series we call Maternity Monday.

Diane Sampson, a Lamaze Certified Childbirth Educator, spends time in the classes she teaches helping parents anticipate the emotional highs and lows having a baby can produce. She explains that the post-partum period (the time after your baby arrives) is an emotionally trying and physically demanding time because:

  • You and your partner will experience new demands on your relationship, where you can’t give each other the same amount of attention and time as you could before.
  • You may mourn for your loss of free time, or even, if you are having a second child, for the loss of alone time with your first.
  • Newborns have shifting, sometimes unpredictable patterns of feeding, sleeping, crying, etc.
  • Sleep deprivation, coupled with the care newborns require, can result in extremely intense emotional strain.

While you may not be able to prepare for the postpartum period, knowing that it’s normal and expected to feel overwhelmed sometimes can help new parents seek help from friends, family and their doctor.

What is Postpartum Depression?

Everyone experiences hormonal and emotional stress when a baby arrives.

Postpartum depression should not be confused with “baby blues,” a hormonal and emotional phase that happens in the first two weeks after delivery. The irritability and sadness from baby blues comes and goes. PPD can occur anytime in the first year, lasts longer and requires treatment.
postpartum depression facts

Postpartum depression:

  • Happens in about 10 percent of women after giving birth
  • Often coincides with returning to work after maternity leave
  • Qualifies as an adjustment disorder, resulting from a woman having issues adjusting to the role and demands of becoming a mother

Signs of Postpartum Depression

Sampson explains that typically, “At the six-week checkup, during the follow-up pelvic exam, women get screened for PPD. Your OB/gyn will ask you a few questions about how you are feeling—about yourself, your baby and your relationships.” Providers consider this inquiry into how a mother feels about her new role as part of the total care of her health.

But, Sampson says, if a new mother doesn’t experience PPD until half a year after giving birth, she could miss being diagnosed, especially if she isn’t checking in with a healthcare provider or counselor on a regular basis.

So, often it’s up to the mother, her partner or a close family member to watch for the symptoms of PPD.

How can you tell if you or someone you know has PPD? Some postpartum depression symptoms to look for:

  • Behavior or emotions that look like regular depression — sadness, low mood, low energy
  • Emotional detachment — mom doesn’t make much eye contact with the baby, doesn’t coo or talk to baby
  • Hyper-vigilance — mother tends towards excessive anxiety about protecting the baby or is fearful
  • Being off kilter, not settling in
  • A lack of joy with the baby
  • Lasts more than three weeks (not just a bad day or week)

Partners Can Get PPD, Too

A husband or partner can also experience depression. With a new baby comes loss of autonomy, loss of attention from the mother. “You’re not the focus of her attentions anymore,” Sampson says.

Of course, the parent who did not deliver the baby will not feel PPD as acutely, not being as physically drained or as hormonally affected. But a baby changes everyone’s routines, including sleep, and lack of sleep contributes to emotional fluctuations for anyone.

Preventing Postpartum Depression: Set Realistic Expectations

According to Lynn McDaniel, MD, our cultural expectations of how a mother should behave after giving birth causes or exacerbates PPD, and explains why it’s so common in the U.S.

“In other societies, you stay in your bed for 40 days; here, we expect you to hop up and get dressed. We make ourselves crazy,” she notes.

“We have new moms whose expectations are that they will be awake all day and feed the baby. But you’re on the baby’s schedule, a 24-hour schedule, not yours.”

So, McDaniel advises, prepare to follow your newborn’s cues. And “don’t worry about preparing gourmet meals or cleaning toilets. Focus on the most important thing, and that’s this new baby.”

One Mother’s PPD

We spoke briefly with Daphne, a local Charlottesville mother, about her experience with postpartum depression.

Daphne experienced postpartum depression after her second child.I felt depressed, very sensitive, emotionally reacting to things out of proportion for sure — teary, easily crying, easily drawn towards the negative perspective of things.”

What helped?My parents came here for 23 days. They noticed I was very teary, and, you know, they helped me with the kids, and also they pushed me to get out of bed and do something, have a shower, put clothes on, go outside, take a walk.”

Daphne discovered her PPD to be temporary.At that moment you feel so devastated and so dark, but it doesn’t mean that feeling will be forever long. Remember it will pass!” Daphne also recommends finding someone to talk to, whether it’s a friend or counselor. “My support network got me through,” she says.

We Recommend

Before you have your baby:

  • Find local support groups and info at Postpartum Support Virginia
  • Read “What Mothers Do… Especially When it Looks Like Nothing” by Naomi Stadlen, a gentle but powerful book based on interviews with new mothers

Be Brave: Tell Your Provider

While the mother may feel hesitant to admit it, and a partner might be hesitant to point out that there might be an issue, avoiding talking to your doctor and getting treated will only make it worse.

If not treated, PPD can last.

As Sampson says, “Some moms may see PPD as a shortcoming in their mothering. You’re supposed to be really happy, and you’re not. This really puts mothers in a bind. We need to make new mothers feel okay with however they feel and asking for help.”

PPD Treatment

Usually providers:

  • Proscribe Zoloft (which is safe for breastfeeding)
  • Refer to counseling, especiallyy a therapist who specializes in PPD
  • Encourage mothers to find support and self-care practices, like taking yoga or other exercise classes and getting out of the house with baby

Know a New Mother? Offer Support

Partners, family members and friends can support new mothers by:

  • Listening
  • Normalizing
  • Encouraging

McDaniel says, “The biggest thing is, in the first few weeks, it’s about baby being with mom. Anything people can do to keep it going is good.” Her guidelines for visitors:

Do:

Clean toilets, make meals, run errands, clean the kitchen, vacuum, mow the lawn, wash your hands before holding the baby, give mom permission to say now is not a good time to visit.

Don’t:

Visit without checking with mother first, bring your kids to visit the baby, get in the way of the mom spending time with her baby.

Do you think you have postpartum depression?

Talk to an OB/gyn or primary care provider.

 
 

A Parents’ Summer Survival Guide

On June 19, 2015 | At 9:52 am

It’s mid-June, which means it’s time to face some bad news: Your kids are out of school for another 1,680 hours.

Even if you take out the time they’ll spend sleeping, you’re still left with a lot of hours, which means a lot of trips to the pool, a lot of screen time, an awful lot of time at camps or with babysitters or with you.

Here’s your guide — and theirs — to getting through it and even having a little fun.

Fun Summer Activities for Kids and You 

Need to keep them active and burn energy? Get some ideas from this infographic on fun exercises for kids.

Or read these eight ways to keep your kids fit, including screen time advice.

Summer Reading for Parents

Take care of yourself, too, by relaxing with a good book. Consider:

Run (Or Walk!) A Race

This local Labor Day weekend tradition benefits the UVA Breast Care Center. Registration opens June 27 and usually fills up within hours. Get more information.

Looking for something the whole family can do? Try ACAC’s Splash for a Cure 5K race and pool party, which benefits the Children’s Hospital’s neuroblastoma research.

Summer Eating

One of our favorite things about summer? The wide variety of fresh, local fruits and veggies make it easy to eat healthy. Try these recipes:

Hosting a barbecue? Keep it light but tasty with four tips for a healthier barbecue.

Safety: Drowning Prevention and Severe Weather

Before you head to the pool, give yourself a refresher on water safety. Sadly, an average of two children drown every day in the U.S., according to the Centers for Disease Control and Prevention. If your kids don’t know how to swim, look into formal swimming lessons, even for toddlers — a study showed they help prevent drowning in kids as young as one.

But just as important, you should know what drowning looks like. Drowning victims are usually unable to splash around and yell for help.

Summer in Central Virginia usually brings severe thunderstorms and flood warnings. Be ready in advance by doing these four things.

Share Your Plans

Have you found some free and fun activities to keep your kids busy? What’s your favorite hot-weather recipe? Leave a comment to let us know!

 
 

Throwback Thursday: Opening the Battle Building (Video)

On June 18, 2015 | At 9:24 am

One year ago this week, one of UVA’s most colorful buildings officially opened for business. The Battle Building at UVA Children’s Hospital brings pediatric primary care and dozens of pediatric specialties under one roof.

We’ve got more to celebrate this year: The building was just recognized for sustainability with a gold rating from U.S. Green Building Council’s Leadership in Energy and Environmental Design (LEED) program.

Watch a virtual tour of the Battle Building:

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Podcast Tuesday: Faster Recovery After Colorectal Surgery [AUDIO]

On June 16, 2015 | At 8:41 am

Patients who undergo colorectal surgery, used to treat colon, anal or rectal cancer, often must spend several days in the hospital to recover. During this time, they’re in pain and unable to eat until their bowel function returns.

But a new recovery program at UVA is getting patients home an average of two days faster. Care teams:

  • Help patients move around, which stimulates the bowels
  • Offer patients soft food sooner
  • Avoid pain medications that slow down bowel function
  • Make sure patients know what to expect, so they feel involved in their care

Listen to colorectal surgeon Traci Hedrick, MD, explain the new process.

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