After baby: Supporting new moms when days are full of tears

This piece originally appeared on the KinderCare blog. It’s shared here with their permission. 

Most parents will name the day their baby arrived in the world as one of their very best days of their lives.

But what if mom doesn’t feel overwhelmed with joy? What if she finds herself crying a few times a day? What if she just can’t find the energy to get out of bed? And what if all of this makes her feel she’s failing as a mother?

“The fact is that most women have some worry and occasional weepiness after they have a baby,” says Dr. Nicole Harrington Cirino, who heads the Women’s Mental Health and Wellness division at the OHSU Center for Women’s Health.

There are very real reasons for the moodiness – beyond first-days-with-a-newborn exhaustion. Immediately after child birth, levels of hormones like estrogen and progesterone (which are 20 to 30 times greater than normal during pregnancy) drop precipitously. These dramatic shifts can have a profound impact on the chemical-messenger systems of the brain, which in turn can alter a new mother’s emotions, concentration, attention and response to stress. Fatigue, exhaustion, oversensitivity, loneliness and crying: These all can be typical responses to these hormonal changes.

The tricky part for a new mom who suddenly finds herself in tears is figuring out whether her reactions are normal, or if she may be exhibiting more serious symptoms associated with postpartum depression, anxiety, or other mood disorders. Doctors call these profound changes perinatal mood and anxiety disorders (or PMAD), and they are not uncommon. One in seven women will experience postpartum depression, or PPD, after their pregnancy.

Here’s how to take care of yourself, and support new mothers, daughters, and friends when they need it – and encourage them to reach out for support if necessary.

Prepare for the possibility

Women who have a history of depression or anxiety are more susceptible to postpartum depression or other mood disorder. Other risk factors include a strong family history of mental illness, an unstable relationship with the father of the baby, economic hardship, an unplanned or high-risk pregnancy, or twins or triplets. But even women without these risk factors may experience PMAD.

If you think you may be susceptible, get your support team in place. In those early months with a new baby, getting (close to) enough sleep, eating nutritious meals and taking (some) time to care for yourself can be powerful tools to guard against depression and mood disorders. Talk to your partner, parents, friends and in-laws about what help you might need – cooking meals, doing laundry, watching the baby while you shower – and what support they can give. Don’t be afraid to get specific!

Take note of your feelings

There is a difference, Cirino says, between “baby blues,” which peaks days 3 to 5 days after childbirth and resolves within one or two weeks, and more serious conditions. The baby blues is a milder form of depression.

“These women are still able to experience joy, and their mood recovers after hours or a day,” Cirino says. “But if a woman’s symptoms persist or worsen for more than two weeks or are severe enough to really interfere with her relationship with her baby, her partner or her ability to provide care for herself, then she may need more professional support.”

It can be difficult, in those sleep-deprived days, to keep track your feelings, so enlist your partner’s help, or jot down your feelings in your phone or on a calendar.

Talk about the changes you’re experiencing

Don’t sit alone with your thoughts. Cirino recommends talking about it with a trusted friend, partner, obstetrician or primary care doctor. Speaking up, she says, can often be the hardest part.

“Some women who experience this often are successful women who are trying to do everything well and can’t admit they may be struggling and need help,” she says. “They may have no history of mental illness and do not understand it, so they blame themselves and what they think are weaknesses as a mom.”

Fortunately, we’ve become a lot more comfortable talking about PPD, partly thanks to celebrity moms like Hayden Panettiere who experienced overwhelming postpartum depression. “It’s really painful and it’s really scary and women need a lot of support,” Panettiere told “People” magazine.

Remember that depression is only one possibility

Not all symptoms show up as depression. According to Cirino, many women have heightened anxiety after pregnancy and birth. This can manifest in physical symptoms of anxiety like heart racing, shortness of breath, tremors, feelings of choking, and insomnia. Other women have obsessive thoughts about cleanliness, safety, their infant being harmed or other worries that they just can’t get out of their head. If you’re not feeling right after giving birth, but it doesn’t seem like “depression,” don’t hesitate to reach out to your doctor or other health care professional you trust.

How to help a new mom in your life who is struggling 

“Be supportive and listen without judging. Make sure moms get sleep and breaks from childcare to eat, exercise, socialize and have time to care for themselves,” says Cirino.

“Partners can also play the vital role of helping moms arrange mental health appointments and follow through on treatment plans, since sometimes it is hard to initiate and follow through on tasks when you are depressed or anxious.” Most importantly, “Reassure them of how much they are loved and help them be in contact with others who care for them and love them.”

 

The Director of Women’s Mental Health and Wellness at OHSU, Dr. Nicole Cirino was trained as a reproductive psychiatrist and has specialized in working with mental health issues experienced exclusively by women across their reproductive life cycle. Dr. Cirino has worked extensively with women and their families who experience perinatal mood and anxiety symptoms for the past 10 years.

 

Volunteer spotlight: Meet Gloria

The OHSU Doernbecher lobby is a busy place. It’s where visitors and employees go to fuel up on coffee, where colleagues convene, where students study and, often, where families and friends meet to talk, to hope, to cry, to get a moment of peace.

If you’ve been in our lobby in the last 11 years, you might already know volunteer Gloria Libby. She sits, focused, at the piano, where she plays music for the benefit of all who pass through our hospital. Unless you happen to spot Gloria’s white cane, you’d never know she’s unable to see sheet music or even the piano keys (though she does have the ability to detect light and shadows). When she was just 2 weeks old, a cerebral hemorrhage left Gloria blind.

 

YouTube Preview Image

 

We sat down with Gloria to ask her a few questions about the healing power of music at Doernbecher.

How long have you been playing the piano?
Well, my mother says I started when I was 5, but I don’t remember playing until I was 6 or 7 years old. I went to residential schools for the blind all 12 years of my education. That’s where I took piano lessons!

What kind of music do you enjoy?
I’m classically trained, so I like to simplify and play some classics. I play a lot of hymns and I like to play oldies – songs for baby boomers and before. I also love listening to Celtic music.

Why did you choose to volunteer at Doernbecher?
[I was already connected to OHSU in a way because] my husband had a job in employee health at OHSU. Initially I reached out because I wanted to volunteer to rock babies in the NICU. I ended up playing the piano at Doernbecher instead and have been doing so for about 11 years now – it’s a special way to reach out to people. I also play at church and at the retirement home where I live.

What’s your favorite part about volunteering at Doernbecher?
I love the people here. I kind of like to hide behind the piano a bit, but I can still be social!  I especially like it when parents bring children to me to say hello. And, of course, I love visits from the animal-assisted therapy teams, including Sallie and Beau!

How do you think music helps calm and heal Doernbecher’s passersby?
I was a certified Music Therapist, and what I’m doing at Doernbecher just feels right. I think there’s a lot of unease at any hospital. There’s trauma going on; there’s life and death going on. Students, too, are learning to face these issues and I think music really helps.

***

Thank you for sharing your time and your music with us, Gloria!

A message from the Oregon Poison Center

In light of the recent arsenic and cadmium exposures in Southeast Portland, the Oregon Poison Center has the following message: The Oregon Department of Environmental Quality (DEQ) and the Oregon Health Authority (OHA) are working around the clock to respond to these exposures.

We are urging concerned citizens to keep abreast with the latest information from the DEQ and the OHA:
Click here to view the DEQ metal emissions website
Click here to view the OHA metal emissions website

The Oregon Poison Center is part of a multiagency collaboration to respond to these exposures. Our toxicology experts provide medical advice to health care providers and the public. Our hotline number is 1-800-222-1222.

Finally, we urge the public to follow our social media channels for the latest information from health authorities:
Follow the Poison Center of Oregon, Alaska and Guam on Facebook
Follow the Oregon Poison Center (@ORpoisoncenter) on Twitter

Additional coverage
“‘Should I get tested for arsenic or cadmium?’ – a doctor responds” via the Portland Mercury
 “Air at SE Portland schools to be tested Friday after toxins detected” via KGW
“Cadmium, arsenic in SE Portland air found 4 months ago” via KOIN

Questions? Please leave a comment below and we’ll do our best to get you an answer.

Give birth to hope by donating cord blood

Every minute a hero is born with the potential to save a life. The Oregon Cord Blood Program works to save the lives of thousands of critically ill patients with blood diseases like leukemia and lymphoma who are in urgent need of a life-saving transplant. Umbilical cord blood, which is typically discarded, is rich with the blood-forming cells that can give blood cancer patients hope for a cure. Donating your baby’s cord blood to a public cord blood bank can help patients get the transplants they need.

Earlier this year, a cord blood transplant saved 4-year-old Michael Wilson’s life after he was diagnosed with Krabbe, a potentially fatal degenerative disease. Krabbe, also known as globoid cell leukodystrophy, is a rare genetic disorder caused by the deficiency of a specific enzyme. Most patients with Krabbe disease present with symptoms within the first six months of life, and approximately 10 percent present later in life (including adulthood). Patients with juvenile onset disease like Michael typically present with weakness, loss of skills and vision loss. Late infantile and juvenile patients regress at an unpredictable rate, but all become severely incapacitated and usually die two to seven years after diagnosis.

Cord Blood volunteer team“It’s amazing that something once considered medical waste [umbilical cord blood] can now be used to save lives,” said Eneida Nemecek, M.D., M.S., M.B.A., project leader of the Oregon Cord Blood Program and director of the OHSU Doernbecher Pediatric Blood and Marrow Transplantation Program. “Unrelated umbilical cord blood donation may be the only chance for cure for patients who have exhausted all available treatment options and for whom no matched family members or adult unrelated donors are found for transplantation.”

What’s the difference between Cord Blood Donation and Private Storage?

When you donate your baby’s umbilical cord for public use:

  • It’s available to any patient in need of a transplant; it’s not reserved for your family members.
  • It’s free for donors. The Oregon Cord Blood Program covers the cost of collecting, processing and storing cord blood units. The donor’s name is kept confidential, and the recipient family’s privacy is protected. Names are not shared with any patient or with the transplant center.
  • It’s collected under strict quality standards to make sure the cord blood unit is usable for transplant. If standards aren’t met, the cord blood unit may be used for research to improve the transplant process for future patients, or the unit will be discarded.

Private Storage:

  • If you store the cord blood in a family (private) cord blood bank, it is reserved for your own family members. Family cord blood banks are available throughout the country for anyone. You are charged a fee for the collection and an annual fee to store the umbilical cord blood.
  • Cord blood is not a biological insurance plan for your child’s future. For some diseases, the patient’s own cells can be used for transplant. However, many diseases treated with transplant may already be present in the baby’s cord blood. For these diseases, a transplant using cells donated from a relative or an unrelated donor is the best choice.

Is there any risk when donating Cord blood?

  • Cord blood donation is completely safe for you and your baby. No blood is taken from your baby. It’s only taken from the umbilical cord itself after your baby is born. Your labor and delivery plan will not be affected. And when you donate your baby’s cord blood to a public cord blood bank, there are no collection or storage costs. Your baby’s cord blood will be listed on Be The Match Registry®, where it’s available for anyone in need of a transplant.

OHSU partners with BloodWorks Northwest to screen and bank collected cord blood units. The Oregon Cord Blood Program is facilitated by coordinator Madeleine Tuson-Turner and a group of nine amazing volunteers to provide this life-saving treatment to those in need.

Interested in becoming a volunteer with the Cord Blood Donation Program? Find out how you can volunteer.

Have questions or interested in donating cord blood? Contact Madeleine Tuson-Turner at the Oregon Cord Blood Program to get started.
About the author: Sean Robertson volunteers as a researcher at OHSU with the Cord Blood Donation Program, the Pediatric Oncology Associate Research Internship program (P.O.L.A.R.I.S.), and as a communications volunteer with the Office of Research and Academic Volunteer Services.

 

What you need to know about Zika virus

Medical and public interest has focused on Zika virus and its effects on the unborn babies of pregnant women. Zika virus is spread by mosquitoes; this virus has been detected in countries in Central America, South America, the Caribbean and Mexico.

Zika virus usually causes mild disease (fever, rash, pink eye, joint pains) and goes away without the person needing much medical attention.

However, there may be a relationship between pregnant women having Zika virus infection, and their babies having a birth defect known as microcephaly (a head size that is much smaller than expected), which may cause significant brain damage and may be life-threatening. The Centers for Disease Control and Prevention (CDC) has strongly advised that pregnant women do not travel or live in areas with Zika virus. If a woman has traveled or resided in a country with Zika virus during her current pregnancy, she is advised to discuss with her doctor how this may affect her baby.

Zika virus has been seen in the continental United States in travelers returning to the U.S. from regions with Zika virus. In addition, the mosquito that can spread the virus does exist here in the U.S. There is the possibility that Zika virus may be spread to non-travelers if they are bitten by mosquitoes who previously bit a Zika-infected person in the U.S.

To prevent Zika virus infection in all persons (including pregnant women), people should focus on preventing and avoiding mosquito bites – this involves wearing long-sleeved shirts and pants, using plenty of approved insect repellent and avoiding being outdoors, particularly at dusk and dawn.

For more information on Zika virus, including possible effects on unborn children, please view the dedicated CDC webpage, the CDC’s Questions & Answers: Zika virus infection (Zika) and pregnancy and the CDC’s Travel Health Notices.

Dawn Nolt, M.D., M.P.H.
Clinical Associate Professor
Division of Pediatric Infectious Diseases
OHSU Doernbecher Children’s Hospital


OHSU in the news:
Our experts weigh in on the Zika virus
Traveling to Mexico? OHSU shares warning over birth-defect-linked Zika virus (January 25 via Portland Business Journal)
Birth defect-causing Zika virus likely headed to U.S. (January 25 via KOIN 6)
Travel advisory for pregnant women and Zika virus expands (January 23 via Bend Bulletin)

 

2015 in review: It’s all about the patients

Social media is great for connecting families, patients, employees, donors and community members with one another and with the hospital as a whole. We love sharing Doernbecher stories and news to help foster a sense of community and provide a space where folks can support one another, get advice from experts and learn how they can give back.

Below you’ll find this year’s most-read blog posts. Happy reading!

 

1. Meet Hope, Doernbecher’s hospital facility dog 
Our chief canine officer, Hope, was a hit from the moment she stepped her paws inside Doernbecher. This post explains more about her training, her personality and how she’s bringing hope to our halls.

2. Eleven things your ‘well child’ wants you to know
Pediatric resident Dr. Antwon Chavis shares how his brother’s autism defined him as a “well child” and shares 11 tips for parents and families with special needs children.

3. Isaiah’s Doernbecher story
Isaiah’s mom, Melissa, shares what it was like discovering her son had a brain tumor and offers tips for parents (stay away from Google!) who are going through similar challenges.

4. Once upon a time: Mae Lin’s Doernbecher story
You’ve probably heard Mae Lin on the radio! She was born when her mom, Dr. Dawn Nolt, was only 28 weeks pregnant. Dr. Nolt walks us through what it was like being both a mother and a doctor in the hospital where her daughter was treated and shares her pint-sized hero’s NICU story. Click here to listen to Mae Lin’s radio spot!

5. Five things you might not know about cancer survivorship
Dr. Susanne Duvall
and Dr. Caroline Grantz shared five helpful tips for patients and families who have completed active treatment for cancer. A great resource for family members and friends who want to know how to support survivors and caregivers, too!

6. Six strategies to improve your baby’s sleep skills
Part of an ongoing series, sleep expert Dr. Elizabeth Super shares six common-sense approaches for breezier ZZZs.

7. Behind the scenes: Doernbecher Freestyle XII
For the first time, we went behind the scenes of the Doernbecher Freestyle program, where our patients are teamed up with Nike designers and developers to create custom shoes and apparel. The Nike team weighed in on why the program is so important and impactful for them – and why it’s the highlight of their year.

8. Our lemonade experience: the Charles family’s story
Doernbecher Freestyle patient-designer John Charles was diagnosed with Crohn’s Disease last year. His parents, Tony and Mary Charles, explain how his diagnosis impacted their family and why they’re so committed to building awareness for others dealing with Crohn’s. Fun fact: John Charles can swallow seven pills at once!

9. A ‘purrfect’ pair: Meet Doernbecher volunteers Huck and Carol
Big cat, big smiles. You’ve likely seen Huck Finn and his human, Carol, wheeling around the halls of Doernbecher. Huck, a Maine Coon cat with a “checkered past,” has an enormous impact on our patients and families.

10. The vaccine every teenager needs
Dr. Jennifer Edman explains why the HPV vaccine is important for all teenagers (yep, girls and boys!) and when they should get vaccinated to prevent infection from the most common strains of HPV.

Give knowledge

At OHSU, we have the flame of knowledge as our symbol. For graduate school, I attended Yale University, whose motto is lux et veritas (light and truth). I like to think that each day in my lab we are working to bring light and truth to bear on the challenges facing human health: specifically, understanding childhood developmental disorders, such as autism, epilepsy and intellectual disabilities.

Most people assume that the government, through the National Institutes of Health (NIH), funds most health science research. While this is definitely true, what many people don’t realize is that often the biggest breakthroughs come from ideas that seemed, at first blush, too risky or that challenged the status quo. As of today, at the 11th hour we look to have a U.S. budget deal that will keep the government running. Even though the NIH’s budget for this fiscal year will have a raise, health science research funding for research labs is still suffering (read more here).

O’Roak lab members on a Marquam Hill hike

It is not uncommon for grants scoring in the top 10-20th percentile to go unfunded. For example, we have a grant in review to look at the risk factors for neuronal tube defects (spina bifida). The grant scored in the 8th percentile and the feedback from NIH was “cautiously optimistic,” but it still might not be funded. A natural result of these pressures is that many researchers are hesitant to propose research that might be deemed too “high risk.”

A counter to this risk adverse climate that has benefited my own work has been the generous support of individuals, families and private foundations. My first scientific publication as a graduate student (Abelson et al., Science, 2005) benefited greatly from funds given to my mentor from a family and foundation to take calculated risks and explore new approaches for understanding childhood psychiatric disorders. This led directly to our discovery of one of the first risk genes for Tourette’s syndrome, a discovery that Science magazine called one of the top breakthroughs of 2005. We went on to leverage similar approaches for autism. Our recent significant advances illuminating the genetics of autism risk would not have been possible without the foresight and significant investment of resources provided by the Simons Foundation and the efforts of many families.

Dr. O’Roak working in his genetics lab

With your support, we can strengthen the light of our flame together as we move onward on our quest for new knowledge that will lead to treatments for these major challenges affecting our kids!

Dr. Brian O’Roak
Assistant Professor of Molecular and Medical Genetics
Oregon Health & Science University

Learn more about the O’Roak Lab here. Families interested in participating in research studies can find out more here or email torch@ohsu.edu.

A Doernbecher patient gives back

Four years ago, 15-year-old Lydia Tam was undergoing inpatient chemotherapy at OHSU Doernbecher Children’s Hospital – and she forgot to pack socks. Our hospital provided her with a pair to keep her feet warm.

Although a sock snafu was the least of her concerns while she was being treated for a brain tumor, it sparked an idea.

“On our drive back to Eugene after treatment, my mom and I were talking about how supportive everyone was – volunteering their time and resources to our hospital,” Lydia said. “I just wanted to give back, so we were brainstorming ways that a high schooler could make a difference in someone’s life.”

She started collecting and delivering socks and slippers to patients at OHSU Doernbecher through her Socks of Care and Kindness (S.O.C.K.) Project, which she launched in 2012.

“I started small by donating socks on 10S, and we kept getting more socks and more support from other people,” she said.

Her deliveries grew as support swelled, and when she visits, she typically brings around 500 pairs of socks for patients in various units.

“I include a little card that explains who I am and how this got started,” she said. “It’s something so little but it makes a difference in someone’s stay at Doernbecher.”

Lydia says her main objective is simple: to bring a smile to someone’s face.

“Having stayed in a hospital for chemo treatments, I know how boring and gloomy it can be,” she said. “Having a pair of socks can bring some joy when you need it most.”

The S.O.C.K. Project collects slippers and socks that are age appropriate and can add a small dose of excitement to a child or teenager’s day with fun colors and characters.

Lydia, now a 19-year-old student at Stanford University, is studying biology and hopes to go into the medical field someday to give back in an even bigger way. For now, though, she’s grateful for her own care team (including Dr. Kelly Nazemi and Dr. Lisa Madison), whom she sees when she’s back from school.

“I was really touched by how Doernbecher cared for me more than just getting cancer out of my body,” Lydia said. “Volunteers and staff cared for me emotionally, and they cared for my whole family.”

Visit The S.O.C.K. Project’s Facebook page to learn more and get involved here. Donations will help warm a child’s toes and heart!

From Doernbecher to Tanzania

Pediatric hematologist/oncologist Dr. Sue Lindemulder knows that families are families, no matter where they are in the world.

For the last three years, Dr. Lindemulder has organized and led a group of Doernbecher fellows on annual trips to Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es Salaam, Tanzania, where they care for kids at children’s hospital Jengo La Watoto and work with hospital staff to develop curriculum and improve their pediatric oncology unit.

We sat down with her to learn more about the training and instruction they provide – and how it ends up making a difference in the way we care for kids right here in Portland.

***

How did the relationship between Doernbecher and MUHAS develop?

Jengo La Watoto children's hospital at MUHAS

Jengo La Watoto children’s hospital at MUHAS

I was sent to Tanzania for three months when I was still in fellowship, and I ended up learning a lot and meeting a lot of people there. Over time I’ve become involved in a Masters program at MUHAS that educates and trains Tanzanian pediatricians to become hematologist/oncologists.

What kind of work do you do there?

I go back as a professor in the Masters program in Pediatric Hematology/Oncology and as a clinician to help with their unit and help manage their patients. I’ve brought senior fellows with me for three years, and Dr. Suman Malempati has also worked and taught there. With multiple providers we are able to spread out to work with students in the Masters program as well as with pediatricians, pediatric residents and others practicing on the pediatric oncology ward. We do formal education with them, we do clinical care, we do on-the-job training, give lectures – basically, whatever needs to happen.

How does their Pediatric Hematology/Oncology program differ from ours at Doernbecher and in what ways is it the same?

Their patient volume is higher – somewhere between 400 and 500 patients show up at their doors every year, and that continues to grow. They have a designated ward for children with cancer, and the facility itself is a large academic medical center like OHSU, although they don’t have the extent of support and ancillary services that we have here (for example, fewer resources in the radiology department or a lab spread over many more patients). If we do a blood count on a child at MUHAS, we might get a result the next day, or we might find out that the blood was lost and we’ll have to try again. As a result, you learn to make a lot more clinical decisions and depend a bit less on lab data. The pharmacy support is also very different – there, the nurses mix the chemo themselves!

One of the biggest differences in Hem/Onc is that there is no PICU, and there’s a single pediatric ventilator for the hospital – and it maybe works. When children get very ill, there really isn’t an alternative for support. If a kid at Doernbecher becomes extremely ill, we send them to the PICU, but the same patient in Tanzania might not make it.Ujasiri house

Another difference is that their nursing staff, though extremely dedicated, is not specifically trained in pediatric oncology as ours are in the United States. That’s something we’re working on; as we bring up the education of their physicians, we need to bring up the education of their nurses. I will say that nurses there can get an IV almost anywhere – it’s a sweaty environment, and tape doesn’t always stay on!

There are a lot of similarities between our hospitals. Tanzania is very much like Oregon, only larger. They have something called the Ujasiri House, which serves families in many of the same ways as Ronald McDonald House does here. They have a great school program at the Ujasiri House and on the unit, just like we do at Doernbecher – and these kids love school. They also have people who are Child Life equivalents – they come and color, play music or do projects with the kids.

What are some of the challenges associated with these trips?

Language is a big one. Most of the clinicians and nurses speak enough English to communicate, but if a patient comes from a village with a dialect that even local Swahili-speaking Tanzanians can’t understand, that can get tricky! I speak a bit of Swahili, so I can get the gist of a lot of things medically. Kids and families think it’s hilarious when I speak Swahili to them – they just laugh and laugh!

The kids come with much more extensive disease than we are used to seeing here due to the time and money required to get to Dar es Salaam. Patients may have first seen a medicine man, then a village provider, then gone to their district hospital, then a regional hospital and then, finally, to MUHAS. Between each visit, they return home to save up money from everyone they know for their next bus fare. Families literally strap their children to their back to get them where they need to go.

By the time they do get medical care, they are very, very ill. Once they get to Dar es Salaam, the care on the unit is mostly provided free of charge. This is huge, but a lot of families can never get there.

How do you foresee this exchange further developing?

We’ll be going back in April, and this year I hope to bring a couple of nurses with us to assist with the formal nursing staff curriculum we’re helping to develop.Hospital art MUHAS

The whole point of the Masters program is to train them in their own country, with their own resources. The flip side, though, is that in order to move their program forward, they need to visit other sites. We’re looking at bringing one of the students who just finished the program over here to do some training with me for a few months. I’d like that to be an ongoing thing.

We’re looking for grant funding, and it would be great to have some additional philanthropic support. The Kiwanis have helped, but a lot of this has been funded out of our own pockets.

How does the Tanzania experience impact Doernbecher doctors?

One of the fellows, Melinda Wu, poses with a patient in 2014

One of the fellows, Melinda Wu, poses with a patient in 2014

The trip exposes us to a degree of pathology we don’t frequently we see, which helps expand our knowledge base. It also teaches you a lot about the management of resources here and ways we can eliminate waste.

The fellows come back more comfortable, with more confidence in their ability to practice. It really reinforces what you know and it stretches what you think you know. My time in Tanzania makes me a better doctor here in Portland.

***

Learn more and follow along with next spring’s Tanzanian adventure with the DCH2Tanzania blog.

The real scoop on teething and sleep

KC FB Profile logoThe Dr. Super Sleep Series is written in collaboration with KinderCare. KinderCare believes that early childhood education creates brighter futures. They are the largest provider of early childhood education in the nation and they are passionate about creating a world of learning, joy and adventure for more than 169,000 children every day. For more parenting resources, crafts, learning activities and family fun, visit their blog.

What’s the deal with teething and sleep difficulties? That’s the kind of thing you find yourself wondering about at 2 a.m. when your very cranky little one just can’t seem to settle down. Like with many baby conundrums, from mysterious low-grade fevers and runny noses, to weird poops or general grumpiness, it’s easy to decree teething as the culprit for bursts of bad sleep. But is it really fair to blame their budding chompers for your snoozing woes? We asked Dr. Elizabeth Super, pediatrician and children’s sleep specialist with the Pediatric Sleep Medicine program here at OHSU Doernbecher Children’s Hospital, for the straight scoop.

“Teething is a very long process that lasts through the first two or three years of life,” Dr. Super says. It can cause a bit of discomfort and even pain, but how much – and how it impacts sleep – depends on your individual baby: Some children have a lot of physical teething-related symptoms and some don’t; some teeth may cause a lot of symptoms (we’re looking at you, first-year molars) and others may not.

TeethingYeah, we know that’s sort of vague. So, what’s the sleepy parent of a sleepy – and possibly teething – baby to do?

First, decide if it’s her teeth. Teething can’t explain all sleep difficulties, so consider whether she’s been showing other symptoms during the day. Indeed, some children are more irritable or run a low fever. You might be able to see, or feel with a clean finger, a new tooth budding just under the gums. She may also have found teething toys or cool things – like wet washcloths from the fridge – comforting. If she isn’t displaying any teething symptoms (and she isn’t sick) then sticking to your usual sleep routine will help her learn to sleep better in the long run. Read more about the building blocks of a great sleep routine here.

Next, adjust your expectations. If yes to the above, then the imminent arrival of a new tooth just might be keeping him up – some babies might fuss over a dull ache, while others might cry or express pain. You can expect two to three days of sleep disruption as the tooth erupts, after which his sleep habits should return to normal.

Know that it’s fine to treat the pain. If it appears teething is painful enough to interfere with your child’s sleep, try giving her Infant Tylenol or, if she’s over six months old, Infant Ibuprofen (Motrin, Advil) at bedtime. “It helps parents to feel better that the pain has been addressed,” Dr. Super says, and it will hopefully help your child get comfortable enough to settle down. The American Academy of Pediatrics doesn’t recommend medicated teething gels that are rubbed on gums, notes Dr. Super, as they have been proven to be ineffective (baby’s drool is enough to wash them away) and can have side effects like numbing your baby’s throat and making it difficult for her to swallow.

Finally, stick (more or less) to the bedtime routine. Your response to sleep disturbances during teething can actually start to create new sleep patterns and routines – e.g., mama comes when I call and rocks me to sleep – that aren’t ideal for building your baby’s longer-term sleep skills. If teething is keeping you both up at night, trust your instincts and find a balance in your response. If a bit of extra soothing works for the few days it takes a tooth to erupt, go for it. But be mindful that the troublesome tooth should arrive in two to three days and when it does, gently steer your baby back to his usual routine. You’ll all sleep better in the long run.

Other posts in the Dr. Super sleep series:
What is your baby’s ‘sleep temperament?’
Six strategies to improve your baby’s sleep skills
Monsters under the bed: Banishing bedtime fears

Battle bad dreams, night terrors and things that go bump in the dark

 

Dr. Elizabeth SuperElizabeth Super, M.D.
Assistant Professor of Pediatrics
Doernbecher Pediatric Sleep Medicine Program
OHSU Doernbecher Children’s Hospital

 

Doernbecher Best in the Country U.S. News & World Report

Categories

Participation Guidelines

Remember: information you share here is public; it isn't medical advice. Need advice or treatment? Contact your healthcare provider directly. Read our Terms of Use and this disclaimer for details.
wordpress stats plugin