Taking Care of Me - The Next Step for Mom

• Feel restless or "moody"?
• Feel sad or "down in the dumps"?
• Feel worn-out?
• Get a lot of headaches?
• Get chest pains?
• Have trouble sleeping?
• Have trouble eating?
• Eat too much or too often?
• Have trouble making up your mind?
• Worry about your baby a lot?
• Have little interest in your baby?
• Feel useless and guilty?
• Feel like hurting your baby or yourself?
• Have little interest in the things you once enjoyed?

• Take a quick walk.
• Listen to music...go ahead, sing along.
• Watch your favorite movies, especially ones that make you laugh.
• Talk to a friend...or lots of friends.
• Eat a little chocolate...it might not reduce stress, but it sure tastes good.

Write down what you can do when you need a quick pick-me-up.

Smoking, drinking or using medicines or drugs to deal with stress gives you a short-term sense of relief but can cause long-term health problems. If you do any of these to get rid of stress, call the NC Family Health Resource Line at
1-800-367-2229 to speak with a substance-use specialist.

Keep Your Stress In Check

Try this. Write down three things that stress you out. Then write down how you could deal with them. Is there someone who could help?

Example: This is stressful...I don’t have time to take a shower.
This would make it better... Someone to watch the baby for 15 minutes a day.
I can ask for help from...My next door neighbor after her kids go to school.

My Stress Busters

Now it’s your turn: This is stressful...(fill in the blank)
This would make it better...(fill in the blank)
I can ask for help from...(fill in the blank)

Before you get pregnant again, try to deal with your stress. Stress in pregnancy may cause your baby to be born too soon or too small to be healthy. Even if you’re not thinking about another baby, remember, half of all pregnancies are not planned. Being pregnant when you don’t want to be can be very stressful. To prevent pregnancy, choose a birth control method that’s right for you. Use the chart below to help you decide.

Your Mouth Says a Lot

You know how good it feels to laugh at a funny joke, right? Laughing and smiling can help reduce stress and make you feel good. But did you know the extra hormones your body produced when you were pregnant could have affected your smile and your baby? Those "pregnancy hormones" and plaque on your teeth could have caused your gums to feel tender, swell or bleed. "Gum" or periodontal disease is often the result.

Women who have gum disease during pregnancy are seven times more likely to have a baby that is born too early or too small. Now that your baby is here, continue to keep your gums healthy. Brush and floss every day. See your dentist twice a year.

What is your mouth telling you?

Private Matters

Some Things to Think About

• How many children do you want?
• How far apart do you want their ages to be?
• How will you keep from getting pregnant now? (Check out the options below)
• Do you have high blood pressure or diabetes?
• Are you overweight or over age 35?

If you answered "yes" to any of these, you could put your next pregnancy in danger. See your doctor before getting pregnant again.

If you are having sex, protect yourself from an unplanned pregnancy and sexually transmitted diseases (STDs). See below for more information.

Family Plans? Choose and Use

It's no secret. If you have sex you can get pregnant...even if you are breastfeeding or just had your baby. To keep from getting pregnant until you are ready, choose and use birth control. Need help finding a method that's right for you? Talk with your healthcare provider. Ask questions about breastfeeding and side effects. One more thing, birth control doesn't prevent pregnancy unless it is used correctly. Even then, some methods offer more protection than others. Use this chart to learn more.

Family Planning/Birth Control Methods

What's That Wet Spot?

It's normal for you to have some wetness or "discharge" from your vagina. The amount is different for each woman. Knowing what is normal for you can help you notice when there is a problem. Call your healthcare provider if your discharge causes itching, swelling, burning, smells bad or is cloudy or not clear in color.

The Truth About Douching

Some women think they must douche to get rid of vaginal discharges and to feel fresh. Normal bathing in a tub or shower is enough to keep your vagina clean.

Q: If it makes me feel clean, what's wrong with douching?
A: Your vagina has "good bacteria" that helps you fight against "bad bacteria" (disease and infection). Douching washes away good bacteria. This allows the bad bacteria to grow. Douching is also linked to infections like bacterial vaginosis (BV) and chlamydia. (See "What You Need to Know About Vaginal Infections" for more information.)

Q: What about using sprays, wipes, powders or other products to get that extra-fresh feeling?
A: Some products, especially scented ones, can lead to problems. Wear panties with a cotton lining and comfortable (not tight) clothes, and keep clean and dry. Make sure you talk with your healthcare provider about any concerns or changes. Douche only if instructed by your healthcare provider.

From about age 11 to 50 a woman menstruates. About once a month she releases blood, an egg and the lining of her uterus. Every woman is different. Some have light periods. Some have heavy bleeding. Some have cramps...and some lucky women don't have any discomfort.

The first period after the birth of a baby is different for each woman. You may have spotting or bleeding off and on for the first six weeks as your body starts to recover. If you are breastfeeding, your period may not come back for a year or more. If you are not breastfeeding, expect your period four to eight weeks after your baby was born. Even if you don’t have a period, you can pass an egg (ovulate). And if you have sex, you could get pregnant. If you miss a period, see your doctor.

WHAT IS NORMAL FOR YOU?

With everything going on in your life it can be hard to keep track of your period. Try using the chart below to help you remember.

• Write the date your period began, ended and how long it lasted. IMPORTANT: If you miss your period, contact your healthcare provider.
• During the month, pay attention to your vaginal discharge. If it causes itching, swelling or burning, has a bad smell, is cloudy or not clear in color see your doctor. You may have a vaginal infection. See below to learn more.

Taking Care of You - Know Your Cycle

My Monthly Period

What You Need To Know About Vaginal Infections

Could It Be An STD?

Sexually transmitted diseases (STDs) are passed through sexual or "close' contact with an infected person. This means
you can get an STD in your mouth, vagina or genital area (the area near your vagina) – even without having vaginal sex.

Some infected women may not have symptoms or symptoms may show up weeks or months after sexual or close contact.
With or without symptoms, STDs don't get better if they are not treated.

Prevention

The best way to prevent STDs is through no sexual or close contact with an infected person. Remember, always use a condom to increase your protection against STDs. See "Family Planning/Birth Control Methods" for more information on condoms.

When To Be Concerned

Infections of any kind are a problem. If you have any of the symptoms listed below or have questions, see your healthcare provider as soon as possible. Delayed treatment could cause pelvic inflammatory disease (PID) which could make it hard for you to get pregnant again.

If you think you have a vaginal infection and are breastfeeding, let your healthcare provider know. Some infections or the medicines used to treat them can be passed to your baby through your breast milk

Before you get pregnant again, have your healthcare provider check you for infections.

Even if you are not thinking about another baby, have a pelvic exam each year. Only your healthcare provider can tell for sure if you have a problem.

Taking Care of You - Up Close & Personal

Now that you've had your baby, your body needs time to get back to normal. Everything may hurt. Your legs may swell. Your belly may be sore, especially if you had a C-section (Cesarean). You may be constipated. And your breasts may be very tender. It's important that you take care of yourself after the baby is born. Get plenty of rest. Don't expect too much from yourself during the postpartum period.

Breast Care

Each month, take a few minutes to check your breasts. Note changes in the way they look and feel. Because breast cancer can affect any woman, it is important you check your breasts for changes in shape, size or appearance. Check your breasts even if you are breastfeeding.

HOW TO EXAMINE YOUR BREASTS

Check!
Lie down. Place your left arm behind your head. With your right hand, feel the left breast all around using the three patterns shown above. Then switch hands. Put your right arm behind your head. Check your right breast. Check under your arms, too.
LOOK!
Before you get dressed, stand in front of a mirror. Look at your breasts.
Do you see changes when you put your hands:

• Down to your side?
• On your hips?
• In the air?
• How do they look when you bend over with your hands on your hips?

Look closely. Do you see lumps or dimples?
Are there clear drops or blood coming from your nipples?
Do you feel pain or tender spots?
If your answer is "yes" make an appointment with your healthcare provider.

The Care And Feeding Of A Mom: Get help with chores - Order take-out - Hire a sitter - Take a long nap

When you lose, you win

Sometimes our bodies need a little reshaping, especially after having a baby. If you are trying to lose some of that extra weight, make sure your healthcare provider knows before you get started. easy ways to get started. Remember, it took time to put on those extra pounds. It will take time to lose them.

If you are breastfeeding, keep in mind that your baby eats what you eat. Choose foods that help your baby grow strong. When you start to lose weight, do it slowly...about a pound a week...so you don't affect your milk supply or your baby's growth.

Before you get pregnant again, eat foods that will strengthen your body and help you have a healthy pregnancy and a healthy baby. Snack on fruits and veggies instead of french fries, chips and sweets.

Even if you are not thinking about another baby, be a good role model. Teach your family good eating habits. This is one of the most important things you can do. A good diet will improve your overall health and the health of the special people in your life.

3 easy ways to get started

1. Cut out just one snack each day.
2. Drink water or low-calorie drinks.
3. Show off your baby; go for a walk every day.

3 easy ways to keep it up

1. Find an exercise friend.
2. Work your way up to 30 minutes of exercise, on most days of the week.
3. Use the Daily Log on page 13 to keep track of your progress.

Now that’s not so hard to do, is it? Try it!
You will lose weight and have fun, too.
Write down your plan here:

Starting today, I will cut back on eating: (fill in the blank)

And tomorrow, I will call (fill in the blank) to go for a walk.

REMEMBER: healthy eating and exercise help control your weight better than dieting alone.

Ready? Set? Aim for a Healthy Weight
A healthy weight for your height can put you on the path to good health. Use the Body Mass Index (BMI) chart to find your "weight for height" score. This number can help you and your doctor decide how much weight, if any, you need to gain or lose. Ask how your BMI score, body shape, family history, diet, smoking or drinking affect your health.

Key:
Underweight - Less than 18 BMI
Healthy - 19-24 BMI
Overweight - 25-29
Obese - 30+

To determine a Woman's Body Mass Index (BMI):
Find your height (far left column). Using the top row, find your weight. Where your height and weight meet is your Body Mass Index score.

Example, if you are 5 feet 4 inches and weigh 140 pounds you are considered a healthy weight.

VITAMINS: TAKE A DAILY DOSE

If you are breastfeeding, chances are you already take a multivitamin/mineral supplement to make sure you and your baby stay healthy. Keep it up.

Before you get pregnant again, take a multivitamin to improve your health and to prevent certain birth defects. But vitamins with folic acid can only help prevent birth defects when you take them before you get pregnant. So start today.

Even if you are not thinking about another baby, take a daily multivitamin. It's good for you. And remember, half of all pregnancies in North Carolina are not planned! That means you could get pregnant when you are not ready, and your unborn baby would be at risk for certain birth defects. Don't let this happen. Start taking your vitamin today. Use the chart below entitled "What Are You Doing This Week" to help you remember to take your vitamin.

Breathe Easy

If you do not smoke, that's great! If you've quit smoking, congratulations! Keep on being an ex-smoker. If you are still smoking, we need to talk...

BODY DANGER!
You've heard it all before, cigarettes and being well just don't mix. You already know that keeping cigarettes and secondhand smoke out of your life is healthier for you, your baby and your family.

If you smoke and breastfeed, your baby benefits from your breast milk but not from your cigarettes. Chemicals from cigarettes, including the drug nicotine, pass through your breast milk to your baby. It would be best to quit. If you can't quit smoking just yet, cut back.

Try these tips so that your breast milk is as safe as you can make it:

• Breastfeed until your baby is a year old, but don't smoke when you nurse or hold your baby.
• Try not to smoke for at least an hour before your baby nurses.
• Pull your hair back and change your shirt to keep your baby from breathing smoke "dust" or particles that settle on your clothes and hair.
• After smoking, wash your face and hands before picking up your baby.
• Drink extra fluids throughout the day.

Before you get pregnant again, try to quit. Smoking can hurt your chances of getting pregnant when you are ready for another baby. Smoking when you are pregnant can cause a baby to be born sick, too early and too small. The baby will be three times more likely to die of Sudden Infant Death Syndrome (SIDS).

HAZY DAYS?

Did the weatherman call for clouds or do you live under the haze of secondhand smoke? Secondhand smoke is unsafe for you, your baby and your family. It "ups" everyone’s chances of getting sick. This means more colds, sore throats, earaches, asthma and allergies. This turns into more trips to the doctor, medicine, taking time off from work, getting a sitter and on and on. Talk about stress. Whew! Secondhand smoke more than doubles a baby’s chance of dying of SIDS.

Even if you are not thinking about another baby, it is never too late to quit smoking for life!

SPIT IT OUT…TOBACCO, THAT IS

There is no safe form of tobacco. Using spit tobacco even for a short period of time can cause cracked lips, bleeding gums, white spots and painful sores on the inside of your mouth. The mouth sores and gums can get infected. This infection can cause your baby to be born too early and too small to be healthy. If you chew tobacco or use snuff and are breastfeeding, you and your baby get twice the nicotine found in cigarettes.

On Cloud 9 - Rising Above Nicotine

Many women quit smoking when they are pregnant. Some quit on their own and continue not to smoke after the baby is born. Others want help. Find a way that is best for you and increases your chances of quitting for good.

If You Use - Body Danger!

Breastfeeding? Even small amounts of drugs in your breast milk can harm your baby. If you use street drugs and breastfeed, get help. Stop breastfeeding until you quit using drugs completely.
Before you get pregnant again, get help now. If you are using street drugs and get pregnant, your baby could be born with health problems or learning and behavior challenges. Even if you are not thinking about another baby, get help. Drugs and alcohol change the way you think, which can lead to making bad choices. Using drugs and alcohol can put you at risk for sexually transmitted diseases or an unplanned pregnancy. Don’t let drugs control your life.

For assistance, call North Carolina Family Health Resource Line at 1-800-367-2229 to speak with a substance-use specialist.

To Drink Or Not To Drink?
Body Danger!

Alcohol, like other drugs, affects the way your mind and body work. Women’s bodies are much more sensitive to the effects of alcohol and more easily damaged than men’s.

If you are breastfeeding, the alcohol you drink goes into your milk and to your baby.

Before you get pregnant again, avoid alcohol altogether. There is no safe amount during pregnancy. If you get pregnant and drink, your unborn baby is at risk for fetal alcohol spectrum disorder (FASD). It is the number-one cause of preventable mental retardation.

Even if you are not planning to have another baby, limit your drinking. It can cause damage to your liver, heart, brain and nervous system. Remember: 12 ounces of beer, 5 ounces of wine and 1.5 ounces of hard liquor contain about the same amount of alcohol.

Body Danger! - What’s in Your Medicine Cabinet?

All drugs have risks. This means you need to be careful about the medicine your doctor gives you and the ones you buy off the shelf. Read the label and any other written information to learn the side effects of your medicine before you take it.

If you are breastfeeding, tell your healthcare provider you are nursing before you take any medication. Some medicines may cause changes in your baby's sleeping and eating patterns.

Before you get pregnant again, throw out any old drugs. Only use medicine given to you by your doctor for a current health condition. If you are trying to get pregnant, make sure your doctor knows.

Even if you are not thinking about another baby, talk with your doctor before you use any new medications. Some medications you buy off the shelf can affect how well prescription drugs work. Did you know that some medications could clash with birth control pills and increase your risk of pregnancy?

8 Good-for-You Checkups

Get your great 8

While you were pregnant, you went to the doctor. After the baby, you had a postpartum visit. Now you take your baby in for well-baby checkups and shots. What’s next? Get Your great eight "Good-for-You" checkups.

What Are You Doing This Week?

Ready? Set? Let's Go!

How about taking care of you? For the next four weeks, use this chart to log some easy ways to get started.
Put a (check mark) in this box every time you eat a fruit or vegetable. Try to get 5-9 each day.
Put an (X) in the box when you take your daily vitamin.
Write in the number of minutes you exercise each day. Try to get at least 30 minutes most days.
Record the number of glasses of water, milk or juice that you drink each day. Try to drink at least six 8-ounce glasses each day.

Need more information? Call the North Carolina Family Health Resource Line 1-800-FOR-BABY (1-800-367-2229)

North Carolina Healthy Start Foundation
1300 St. Mary’s Street, Suite 204
Raleigh, North Carolina 27605
919-828-1819
919-828-1446 FAX
919-828-7470 FAX for ordering materials
www.NCHealthyStart.org