Your Healthy Baby: Live Question and Answer Session, January 20, 2004

From planning a family to prenatal care, breastfeeding and baby milestones.

Do you have questions about keeping your baby healthy from conception through the first year?

A live question and answer session about pregnancy was held on Tuesday, January 20, 2004. Thank you to our sponsors and healthcare professionals at Columbia St. Mary's and Advanced Healthcare.

To find a physician to answer your questions now, please use the physician search found at the top of this page.



Q: Dennis Jenders of Oak Creek, Wisconsin -
I'm getting a bit older, when planning a family what age would you consider the upper threshold for having a baby? (For Men and Women) Will having a child earlier make consecutive pregnancies easier? Thanks!
A: Moderators - Good question. There is no absolute age at which we do not recommend pregnancy. The risks of being pregnant do increase with age but as long as the couple is informed, the only limitation is that women will at some point stop producing eggs. Men produce sperm into advanced age (70 and beyond).
Gerald L. Vitamvas, MD, FACOG
Advanced Healthcare 414-352-3100




Q: Alan of Colgate - My daughter is 18 months old and she had 6 ear infections in the past 6 months - since she starts the daycare. I heard different opinions for the sickness, my question is - IS DAYCARE THE MAIN REASON TO CAUSE THIS KIND OF PROBLEM, THE BIGGER DAYCARE IS WORSE OR THE SIZE DOES NOT MATTER? Thanks
A: Moderators - Size of daycare does matter. A daycare with more children slightly increases the chance of the child getting a cold, which, in turn increases the chance of an ear infection. If you have an option, you may wish to seek a daycare with fewer children. Unfortunately, many parents do not have a choice. Gerald L. Vitamvas, MD, FACOG Advanced Healthcare 414-352-3100




Q: DeeDee of Milwaukee - I am a 38 years old African American (do not have children) and would like to try and get pregnant in a few years. Is there anything I can do now to help my chances of getting pregnant? vitamins, diet or exercise. I am overweight and wondered would that hinder me in any way from becoming pregnant?
A: Moderators - Good general health does improve fertility. A good diet, avoidance of smoking and drugs and maintanence of a normal body weight will improve your chances. Gerald L. Vitamvas, MD, FACOG Advanced Healthcare 414-352-3100




Q: Jennifer of Kenosha - How long should you be off birth control pills before you start trying to conceive?
A: Moderators - Jennifer, Most experts agree that you should use some form of barrier contraception (e.g. condoms) until you have your first normal period. Usually this would be about 4-6 weeks after stopping the pill. However, if your periods were irregular before starting the pill, it may take a bit longer. Paul Lucca, MD OB/GYN Good Hope Road Center 414 351-3798




Q: Mark of West Allis - My wife is currently pregnant with our 2nd child. With our first she had a difficult time breast feeding. If she encounters problems this time, would it be best to switch immediately to formula vs. a mix of breast feeding and formula?
A: Moderators - Generally, one must start with breast feeding exclusively. The milk supply depends on and responds to the demand (how often the baby nurses). Supplementing with formula will cause the milk supply produced by the breast to decrease. If she has problems nursing this baby, she may benefit from a lactation consultant, such as is available through CSM hospitals.
Gerald L. Vitamvas, MD, FACOG
Advanced Healthcare
414-352-3100




Q: Josh of Shorewood - Are there any studies that show that children in day care are more prone to consistently picking up colds? Does this build there immune system to fend of colds as they grow older?
A: Moderators - Children in day care are exposed to more cold viruses and may have more colds. There is one recent study that suggests that children with such exposure may develop immune systems better able to deal with such infections. Unfortunately, there are enough different cold causing viruses for people to have three colds a year for a lifetime. Gerald L. Vitamvas, MD, FACOG Advanced Healthcare 414-352-3100




Q: Heather of Mukwonago - My baby is 3 1/2 weeks old and he's got tiny bumps on his forhead and now spreading to his cheeks. I believe it's baby acne. Is there anything I can use or should be doing to help it go away or prevent it from spreading? And how long will he have this? Also, may son gets the hiccups about once a day. Why is he getting them and how can I help him make them go away quickly?
A: Moderators - Dear Heather, The rash that you are describing has a variety of names, usually infant acne or seborrheic dermatitis. It is likely caused by a combination of high levels of male hormones, which is normal for that age, and oily hair and face and an inflammatory reaction to the oil. I find that this rash is remarkably responsive to daily hair wash with a mild baby shampoo and also one to two times daily face wash with a mild soap like Dove Sensitive skin, especially to the nose and eyebrows. If this combination doesn't take care of it, you can ask your pediatrician for a mild anti-inflammatory ointment. Sincerely, Susan R Bernstein MD Columbia/St. Mary's Physicians, 414-291-1520




Q: Tim of Milwaukee - My wife and I just found out that she is pregnant. We both smoke and do plan to quit. But at just about 3 months into her term could smoking have affected the child?
A: Moderators - This is a hard question to answer exactly. There is no question however that quitting now will help the baby. Smoking during the pregnancy increases the rate of small babies, the rate of asthma after birth, and the rate of birth defects. Smoking by the mother is more harmful but it is easier to quit if you have a partner. By quitting now you will gain most of the benefits. Quitting is hard but the baby's health may be the motivation you need. You can contact you doctor or since you obviously use e mail you could check websites for the american cancer society, American heart association and Wisconsin Coalition Against Tobacco (that may not be the exact name). Anti smoking medications may help you but would probably not be adviseable during the pregnancy. There are many different ways and different things work for different people. The usual tricks are getting rid of smoking materials, making lists of advantages (money saved, lowered risk of cancer and heart disease, better appearance, lower rate of motor vehicle accidents, lower insurance rates etc etc), letting others know that you are quitting, avoiding situations that trigger the urge to smoke (cigarettes in the care, coffee at certain locations, hanging out in smoky locations etc). There are of course others. We know this is hard. Best of luck and congratulations on your pregnancy. Thomas Chatton MD Advanced Healthcare Cedar Creek Center Grafton, 262-375-3700




Q: Jane of Milwaukee - My husband and I will be re-fininshing and painting some furniture for our baby's room. Is there any specific paint that we should be using? Or as long as it's a lead-free paint (which it should be since it's manufactured after 1978) should we be safe ?
A: Moderators - Any modern latex or oil-based paint should be fine. Gerald L. Vitamvas, MD, FACOG Advanced Healthcare 414-352-3100




Q: Ann of Milwaukee - We're expecting a baby boy in March. My husband would prefer that our son not be circumcised. Are more parents not having their babies circumcised? Will he have any health risks as he grows up? Thank you.
A: Moderators - Circumcision is an elective operation. In my practice, more boys are being circumcised than not, but that is not a compelling reason to do circumcision. Men who are not circumcised are at slightly greater risk for penile skin cancer, and conditions of the glans- balanitis (inflammation of the glans) and phymosis (stricture or scarring of the foreskin around the glans). These can be prevented by proper cleaning habits during one's lifetime. Gerald L. Vitamvas, MD, FACOG Advanced Healthcare 414-352-3100




Q: Michelle of Hartford - How long does it take for a woman's menstrual cycle to regulate after weaning? I've been in the process of weaning my 11 mo. old for the past month. Last week we stopped breastfeeding entirely. I was expecting my period this past weekend but it hasn't started yet. I resumed menstrating at 7 mo. postpartum and was breastfeeding about 7 times per day up until a month ago. My periods were regular the past 3 months. I did take a home pregnancy test two days ago and it was negative. Does weaning throw your body off kilter hormonally? Could this be why I am late this month? Can you explain what happens to your body during the weaning process? Thanks
A: Moderators - Michelle, The fact that this currently expected period is late is not a big surprise. For many women, regular menses don't start until 4-6 weeks after they stop nursing entirely. It's encouraging that you've already had 3 regular periods so far. I would expect that they still may be a little erratic for another month or so. If you're trying to get pregnant, keep trying. If you're not, use some form of barrier contraception for now and then you'd have the option of starting birth control pills with your next menses. Paul Lucca, MD OB/GYN Advanced Healthcare, Good Hope Road 414 352-3100




Q: Sandra Wells of Waukesha - I'am forty-three years old and on my third child. I hear about high risk preganancies after forty. If I don't smoke or drink and take very good care of myself, what are my chances of a full term healthy pregnancy. And also what is the average caloric intake for a healthy baby but not to gain too much weight. I gained aprox- 60 pounds in ten years, I don't want this to happen again. I just lost 20 pounds in the last three months and just found out I am pregnant. I need good direction for over fourty and pregnant advice. Please help.
A: Moderators - At your age you are at greater risk of a baby with Down's Syndrome. I would estimate that risk for you at about 1:40. Otherwise, based on what you have told me, you are otherwise not at unusual risk. NOrmally, one needs only about 250 calories a day during pregnancy to grow a healthy baby. Gerald L. Vitamvas, MD, FACOG Advanced Healthcare 414-352-3100




Q: Jennifer of Kenosha -
I'm 33 years old and my husband and I have no medical issues. You read a lot about Down's Syndrome and the age of the mother being an indicator of this possibly happening. What are the chances of this happening to us?
A: Moderators - The risk of having a Down's pregnancy increases with both paternal and maternal age. At a maternal age of 35 the risk is 1:270. At 33 or 34, it would be somewhat less than that.
Gerald L. Vitamvas, MD, FACOG
Advanced Healthcare
414-352-3100




Q: Jennifer of Kenosha - How long should a couple wait before consulting with an infertility specialist?
A: Moderators - Your OB/GYN should be able to initiate a basic infertility work-up including cultures, a semen analysis, a test to be sure your fallopian tubes are open, and an evaluation of ovulation. He/she may also offer Clomid treatment with or without inseminations. This basic workup should be initiated after a year of unprotected intercourse and be able to be completed within 3 to 6 months. The pace can be sped up if your age is a significant concern




Q: CC of MKE - Is "the patch" a safe method of birth control to use while nursing?
A: Moderators - The patch, or Ortho Evra, contains both estrogen and progesterone. These are the same hormones which are in birth control pills and may suppress breast milk supply if used before 6 weeks postpartum. Generally, I recommend using a progesterone only method like the minipill or Depoprovera until nursing is completed.




Q: Tammy of Milwaukee - When I was expecting my baby had a fast heart rate from about 32 weeks until due date. I had twice a week monitering with the non stress test. At one point during a doctor visit the fetal heart rate was at 190 bpm. I was rushed to the hospital and the baby's heart rate returned to normal. My doctor was worried and sent me for a fetal echocardiogram at 37 weeks which turned out normal (as far as they could tell). My doctor never really could tell why the heart rate was high. Any ideas? Should I feel comfortable without getting a specific answer? My blood pressure was also rising as the pregnancy progressed but I was never pre eclamptic.
A: Moderators - If your baby is already delivered and is healthy, I would not be concerned. If you are currently pregnant, the twice weekly fetal heart rate monitoring is sufficient if it is normal. This is only a screening test and if persistent abnormalities are present, further testing may be indicated. A faster heart rate in and of itself is not dangerous. Other characteristics are equally important. If any distress issues are present and you are already full term, delivery would be appropriate.




Q: Leslie of Mequon - how do I go about finding a physician that supports natural childbirth/having a doula? It's very hard to!
A: Moderators - Not so! Columbia Center Hospital has an active doula program and all of Advanced Healthcare, Good Hope Road Obstetricians are familiar with and work with that doula program. Gerald L. Vitamvas, MD, FACOG Advanced Healthcare 414-352-3100




Q: Lori of Brookfield - At my son's 18 month old well-baby visit the doctor mentioned that he had a hernia and related it to his "outie" belly button. Is every "outie" considered a hernia? Does it hurt the baby and should he have the surgery to correct it? Is there harm in NOT having surgery?
A: Moderators - It is not uncommon for infants and toddlers to have a small defect in the abdominal wall at the belly button, and this is referred to as an umbilical hernia. Generally these hernias are without any symptoms and they usually do not require intervention. If the hernia is larger than a small fingertip, then a repair may be required at some point. Your doctor can monitor the hernia over time. John Goetz MD Advanced Healthcare 262-284-3456