Spring Letter 2016

One of the most common questions I hear from first-time pregnant women is, "How will I know when I'm really in labor?" I usually respond, "You won't be smiling at me or anyone else." And then we talk about the stages of labor.

Early or latent labor begins when you start to get regular contractions that typically feel like uncomfortable pressure in the back that moves around to the belly. The pain can be mild or moderate, doesn't last very long and is spaced about 15 minutes apart.

During early labor, you can call your doctor to let her know things are starting to roll, but be prepared to be told not to come in just yet. Early labor is best spent at home where you can walk, rest, bathe, listen to music and have a light snack.

Active labor sets in when contractions become stronger, last longer and come less than five minutes apart. At this point, if you're not already at the hospital or birthing center, it's time to head in.

In active labor, contractions start to really hurt and it's hard to walk or talk through them. You are no longer smiling at your nurse or anyone else. Breathing and relaxation techniques can help, but many women ask for pain medication – most commonly, an epidural. The cervix dilates from four to seven centimeters during active labor.

Transitional labor is the most intense phase and can last from a few minutes to a few hours. Without an epidural, women feel strong pressure in the lower back or pelvic area. Some women become shaky, sweaty, nauseous and may vomit. This stage is draining, but the cervix dilates to 10 centimeters and you're almost ready to push.

It can take a while for first-time mothers to pass through all the stages and phases of labor, but the most intense part is usually the shortest. And, I can assure you from my experience helping many women through labor and having a son of my own, when your newborn is finally on your chest, any pain or anxiety you may have felt will quickly drift away – and you will smile like never before.

Warm Regards,

Linda Ciampa, RN

Winter Letter 2016

You may be surprised to learn that early dental caries is the most common, chronic disease of American children. And even though tooth decay has decreased or stayed the same in some age groups, early childhood caries – especially among the youngest and poorest populations – continues to rise.

In what some are calling a "seismic shift," the nation's pediatricians are stepping in to help. This makes sense because pediatricians see babies and children more often than dentists – and oral health is an integral part of a child's overall well-being.

Against this backdrop, pediatricians are being taught how to identify early dental caries, provide prevention and apply fluoride varnish during routine office visits. In fact, at the 2015 national conference of the American Academy of Pediatrics (AAP), physicians got hands-on experience applying the varnish to the teeth of volunteer youngsters.

It takes only a few minutes for a doctor or dentist to paint fluoride varnish on the tops and sides of a child's teeth. The application does not hurt, dries in minutes and the child can eat soft, room-temperature food or liquids shortly afterwards. This simple treatment goes a long way in the prevention of tooth decay.

Even with pediatricians joining in the campaign against cavities, dental visits are still important. In fact, the AAP, American Academy of Pediatric Dentistry, American Dental Association and American Association of Public Health Dentistry all recommend children visit a dentist by age one or when the first tooth appears. However, children who do not have the access or opportunity to see a dentist this early on can benefit from knowledgeable pediatricians.

During your baby's next checkup, talk with the pediatrician about what oral care or fluoride varnish is appropriate. And keep in mind, fluoride treatments are effective – but it is the parent's role to help their child with brushing, flossing, getting regular checkups and eating a healthy diet.

Warm Regards,

Linda Ciampa, RN