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How to Handle Mastitis when Breastfeeding

Thursday, January 23rd, 2014

Mastitis is, simply put, an inflammation of the breast. It can occur without apparent cause, but it often occurs during breastfeeding. In fact, about ten percent of breastfeeding women experience mastitis. Mastitis can be particularly problematic in women who wish to continue breastfeeding, because it is often painful and women suffering from mastitis are very likely to wean their infants during this time.

Mastitis is caused by infection by bacteria that enter the breast through the nipple; the cracked and sore nipples common in breastfeeding women make perfect pathways for the bacteria to get in through. Most commonly occurring during the first six months of breastfeeding, it can add to the already-considerable burden of caring for an infant and increase the mother’s fatigue and stress. It often leads to the cessation of breastfeeding, but breastfeeding with mastitis is safe, and it is usually cleared up easily with medication.

Symptoms and Treatment of Mastitis

Usually the first thing a woman with mastitis notices is a painful area in one of her breasts. The area may also be warm and red. She may also experience body aches, chills, and fever. Swollen and painful lymph nodes, flu-like symptoms, and a faster than normal heart rate are signs that the infection is getting worse.

Mastitis is usually easily diagnosed by observation of the symptoms; specific tests are not typically needed. If you have symptoms of mastitis, don’t hesitate to see your doctor; an antibiotic will usually cure it relatively quickly. It is safe to breastfeed while taking antibiotics, so feel free to continue to do so, unless your doctor directs you otherwise. During treatment, help your body heal and yourself feel better by resting more, drinking plenty of fluids, and using warm or cold compresses on the painful area. You can also take acetaminophen or ibuprofen for pain. If you think you have mastitis, get medical attention promptly; delaying treatment can lead to complications which can be harder to treat.

Breastfeeding (or Not) with Mastitis

If you are determined to continue breastfeeding, you can do so safely with mastitis. Make sure to empty the affected breast completely each time you breastfeed in order to prevent a dwindling milk supply. If it is too painful to breastfeed much on the affected side, use a breast pump to completely empty the breast on a regular basis.

However, for some women, mastitis presents either too difficult a situation in which to continue to breastfeed, or a good opportunity for weaning for those who were planning it soon anyway. Caring for an infant is extremely challenging, and formula presents a perfectly nutritious and healthy option for feeding your baby. I know that most women feel like they “should” breastfeed, but in fact, millions of completely healthy and well-adjusted people were never breastfed.

Don’t worry about “bonding,” either. Feeding your baby should be a time to interact closely with him or her, but it’s the physical contact and the attention that matter, not whether the milk being fed is coming from a breast or from a bottle.

For more information on this topic and others, see my book, Inside Information for Women.

– Yvonne S. Thornton, M. D., M. P. H.

What about Postpartum Depression?

Thursday, January 2nd, 2014

Regardless of how much you have looked forward to the birth of your baby or how happy you are about it, having a baby is extremely stressful. A range of emotional reactions are expected and normal, including sadness, “baby blues,” or some depression. However, if you find yourself with feelings of depression that don’t go away within a few weeks, you could have a condition called postpartum depression. This is a serious condition that requires that you see your doctor as soon as possible to discuss treatment and support options so that you are healthy and able to take optimal care of your new baby as well as yourself.

The baby blues are common and mild, and may include symptoms such as sadness, moodiness, irritability, and trouble sleeping. These symptoms appear within a few days of giving birth and improve within a couple of weeks. Postpartum depression, on the other hand, is more serious and the symptoms are more severe and last longer.

Symptoms such as a lack of interest in your baby, worrying that you might hurt your baby, lack of interest in personal hygiene, lack of motivation or energy, feeling worthless or guilty, or thoughts of death or suicide are examples of the types of symptoms that should alert you to the fact that you may be dealing with something beyond normal baby blues.

What Causes Postpartum Depression?

It is not well understood why postpartum depression affects some new mothers and not others. However, there are a number of causes and risk factors that may contribute. Changes in hormone levels after childbirth, physical pain, insecurity about your changed body, exhaustion, and the stress of taking care of a new baby can all play a role in the development of postpartum depression.

In addition, it is known that some women are more likely to get postpartum depression, such as those who have a history of depression, a history of severe PMS symptoms, medical complications with the pregnancy or delivery, and a lack of support from friends and family. In fact, this study shows the important role that peer support plays in preventing and lessening postpartum depression.

How to Treat Postpartum Depression

To start feeling better, it is very important to take care of yourself. Making sure you get enough sleep, which may sound impossible when you have a new baby, but being exhausted will worsen your depression. I was told from a wise mother of several children, “When your baby sleeps, you sleep.”  No vacuuming, washing clothes or paying bills. Enlist help if at all possible so that you can get enough rest. And when awake, do not spend every waking minute caring for your new baby, your other kids, or your house – take breaks from mommy duty to pamper yourself.  That may be easier said than done when you have a maternal sense of danger if your baby is not within your sight every minute.  Even taking a shower may be difficult for some new mothers.  Single mothers have the most difficult time of balancing their lifestyle with the arrival of a newborn.  Instead of meeting a friend for coffee, ask that friend if she (or he) can come over to spell you from the rigors of motherhood for a few hours.  And, when she’s there, take a long, hot bath and do whatever simple things you enjoy to recharge and relax.   It DOES “take a village” to raise a good kid without exhausting yourself trying to do it alone.

You can also get closer to feeling like yourself by eating a healthy diet, getting plenty of mood-enhancing sunshine, and easing back into a regular exercise routine. A 30-minute walk each day is a good way to start, and your baby will probably love it, too.

Finally, make sure and take advantage of the help and support others offer – or be proactive about asking for it. Stay in touch with your friends; make plans with them and do not let yourself become isolated. Talking about your feelings can help, too.

As stated in my blog back in 2010, “Everyone feels sad some of the time. It’s normal to have a bad day. But if your bad day stretches into weeks, for your own sake and the sake of your baby, you need to get help. If you don’t have a therapist, ask your ob-gyn for a referral if you experience feelings of hopelessness, sadness or despair. Don’t suffer needlessly. Help is available.”

Talk therapy, hormone therapy, and medications such as antidepressants can all be highly effective in relieving postpartum depression.

– Yvonne S. Thornton, M. D., M. P. H.

Congratulations, It’s Twins!

Thursday, October 31st, 2013

An increasing number of expectant parents are hearing those words these days. If you are expecting twins (or more), then one of two things has happened. In natural twinning, either your body has released two eggs, and they have both been fertilized, or one fertilized egg has split into two. The former will result in fraternal twins; the latter, identical.

Learning that you are expecting twins is normally quite a shock. It can take some time for the news to sink in, and for all the concerns and questions to arise. You may be concerned about pregnancy complications or what the birth will be like; you make also worry about being able to cope with having two babies at once. These concerns are completely normal and common.

Realize that the majority of twin pregnancies turn out just fine. You can probably expect to be tired throughout the pregnancy and require a lot of rest; this is your body telling you what it needs, so be sure to listen. Some pregnancy symptoms can be exacerbated with twins, such as morning sickness (which can actually occur any time of day). Your higher levels of hCG will often mean more nausea and possibly vomiting than women with singleton pregnancies experience.

Later in your pregnancy, you may also experience other symptoms to higher degrees, such as shortness of breath, constipation, heartburn, and bloating. Back or hip pain may also be more of a problem as your babies grow.

Another difference you will notice in your twin pregnancy is increased weight gain. Understand that if your are average weight, you will need to gain more weight than women who are carrying only one fetus – but also realize that it needn’t be a lot more. While mothers of a singleton pregnancy need only eat 100-300 calories more per day, a mother of twins needs to ingest about 500 more calories per day. More may be advised if she is underweight to start with; if she is overweight, less is fine, as long as the babies are growing and healthy.

Mothers of twins should expect more prenatal care, as well. More ultrasound examinations are common to keep an eye on how well your twins are doing. You will also have regular blood pressure and urine checks, because as a pregnant woman expecting twins, you have a higher likelihood of developing high blood pressure, gestational diabetes, preeclampsia, and anemia.  Because of the higher risk of depleting the maternal iron and calcium stores with a twin gestation, additional supplementation with prenatal iron and calcium is prescribed in order to prevent anemia or osteoporosis later in life.

Look out for the same danger signs as in any other pregnancy and report them to your doctor immediately. If you aren’t sure whether a symptom is normal or not, or even if you just feel instinctively that something isn’t right, consult with your doctor to be on the safe side. Report any of the following symptoms to your doctor:

  • Severe headaches
  • Sudden swelling
  • Vomiting
  • Abdominal pain
  • Excessive fatigue

Take all the help you can get during this challenging pregnancy. Let others care for older children regularly so you can rest; allow your partner to run errands and do more than his or her normal share of the housework. The important thing for you to focus on is keeping yourself rested and healthy. And try not to worry; the fact is that the most likely outcome of your twin pregnancy is two healthy, normal babies.

– Yvonne S. Thornton, M. D., M. P. H.

It Is Okay to Decide Not to Have Kids

Thursday, August 15th, 2013

For many women, the choice to become a mother is an easy one. To these women it feels natural; they look forward to it and, usually, love it once it happens. For other women, the choice is also clear – the choice not to become a mother. For many women, this is an easy choice to make, but not such an easy one to share with their loved ones. After all, we still live in a culture that expects women to become mothers. A girl becomes a woman, gets married, and has kids. A woman who deviates from this plan is somehow “wrong.” Women have fought so hard over the years for equal rights, including the right to make choices for themselves – so why are we still so hard on women who make the choice to remain child-free?

Lately, the ranks of childless women have been speaking up in a big way. They are making themselves heard loud and clear: We don’t want kids. Period. Not, we don’t want kids now, but we realize we might change our minds later. Not, we can’t have kids. But we don’t want them. It is not going to happen.

These women will not be made to feel guilty because so many women want kids but can’t have them. Nor will they buy into the idea that they are selfish or bad because they choose freedom over babies. And they do not accept the premise that they somehow do not understand their own desires or “will change their minds later.” They are bravely claiming for themselves lives of free time, solitude at will, career immersion, or vacations at the drop of a hat – basically, they are choosing to do what they want to do, when they want to do it.

Unfortunately, an “us and them” mentality has begun to take shape around this issue. Moms, understandably, get defensive when they feel like their choices are being disparaged. Childless women feel ostracized by moms. This is a disturbing trend that we should nip in the bud, because women can potentially be such a great support system for each other.

And let’s be honest: the fact of the matter is that no matter what you choose, you are going to be judged for it. You are either fat and lazy or thin and stuck-up. You are either poor and uneducated or rich and mean. You are either a bad mother with too many kids or you are a selfish, close-minded woman with no kids. You can’t please everyone, and sometimes, you can’t please anyone but yourself. So please yourself. Life is short; how you live yours must be your own choice.

As women, it’s time we stop tearing each other down and start empowering each other to make individual choices – and supporting each other in those choices. It’s not “us and them.” We are all still women, with dreams and plans and feelings. Let me empower you: it’s okay not to have kids – and it’s okay to have them. No one can make the choice for you but you.

– Yvonne S. Thornton, M. D., M. P. H.

Apgar Scores May Predict ADHD

Thursday, October 25th, 2012

As you’re nearing the end of your pregnancy, you’ll probably be relieved in some ways. You’ll be able to lift your own ban on caffeine, start working back towards your normal body weight, and say goodbye to the relentless back pain. At the same time, you might be nervous about entering motherhood. There are many questions you’ll need to know the answers to upon your baby’s birth, and motherhood will become your new unpaid – albeit wonderful – full time job. One concern many mothers have as their baby starts to develop is the risk for attention deficit hyperactivity disorder (ADHD).

Many kids are prescribed with different medications for ADHD, and there is endless controversy surrounding it. Unfortunately, the disorder affects many children and their ability to learn in a classroom setting, so it can be detrimental if left untreated. The worst part is that we as physicians are unable to find the cause for the condition. However, one recent study suggests that you might get a clue about your child’s susceptibility to ADHD right after birth.

After you’ve given birth, your doctor will perform an Apgar examination. The test measures your baby’s vital signs such as his or her heart rate, muscle tone, and breathing. Essentially, it is a score that measures the health of your baby immediately after birth at 1 and 5 minutes.   It tells the pediatrician whether or not your newborn needs to be resuscitated because it doesn’t demonstrate the essential hallmarks.  Your baby will be ranked on a scale of 1-10, and babies with a score under 7 need additional medical attention. Amazingly, the results of the recent ADHD study show that children with a low Apgar score immediately after birth are more likely to develop the disorder later in life. Even in children with a score of five or six, their risk was 63% higher than those with a score above seven.

If your baby is born with an Apgar score below seven, you shouldn’t immediately assume that he or she will suffer from ADHD. Instead, you should be prepared and look for signs as your child grows up that he or she might need some assistance in school. Being a good mom is tough, but knowing in advance that your child is at risk makes your job a little easier. The low Apgar score could be a sign that there were some developmental problems in the womb, and you should assist your child accordingly should any learning disabilities present themselves.

– Yvonne S. Thornton, M. D., M. P. H.

What Does Your Baby Bump Tell You about Gender?

Monday, September 17th, 2012

We’ve all heard a few old wives’ tales concerning the prediction of gender in a developing fetus.  Some say that the position of your belly is an indicator of the gender.  If your belly is protruding on the lower side, then it’s a boy, and if it has settled fairly high, then it’s probably a girl.  If only it were this easy to tell.  Unfortunately, it is not this easy, and now there is proof.  When I was pregnant with my two children, I was carrying “high” both times and yet, I have a son and a daughter.   If looking at a pregnant woman’s belly forecasts the gender, then we could do away with prenatal studies.

Some people rely on the lunar calendar and still others have come up with the curious baking soda test.  While these supposed gender predictors might be fun and grandma might claim to be absolutely sure of their accuracy, these and the location of your belly simply have no correlation with the gender of your baby.  Researchers in Australia who had been testing various methods for gender prediction decided to take on the baby bump test.  Their test would try to correlate the position of the placenta with gender prediction.  Using ultrasound to identify and record the location of the placenta, they observed 277 pregnant women.  They found that the rate of males and females born was almost 50-50 and that there seemed to be no connection between the location of the placenta, and gender.  Instead, they found that the assessment of the baby’s genital tubercle at 12-14 weeks as a prediction technique was much more useful, with an accuracy rate of more than 85%.  This is the tiny little nub that starts to protrude as your baby develops.  Doctors have found that the angle of this nub can tell them a great deal about the resulting genitalia.

Although it may be tempting to quote this study to grandma, it is a sad commentary on our culture when we seem to have an insatiable need to identify gender.  There really shouldn’t be any need to identify the gender if we are going to treat little girls the same as little boys.  But, we don’t.  This obsession with trying to identify gender (often leading to feticide in many countries) only underscores the lingering sex discrimination that still exists in the 21st century.  What difference does it make whether the growing fetus is a boy or a girl——unless they are going to be treated differently?   When someone asks, “Is it a boy or a girl?” They are  knowingly or unknowingly perpetuating the idea that one gender is better or worse than the other.  We should be asking, “Is the baby healthy?”

The next time people try to tell you that your belly looks like it’s holding a boy or girl, you can simply smile and nod and let them have their fun.  Instead, rely on your doctor and hope you have a healthy baby.  Even better, leave it up to fate and wait for the surprise.


– Yvonne S. Thornton, M. D., M. P. H.

Don’t Forget to Ask

Monday, August 6th, 2012

When you are pregnant, there are a lot of things running through your mind at once, most of them being questions.  As the date of delivery approaches, those questions become all the more important and all the more difficult to remember to ask.  Here are a few important ones that you should add to your list.

What if My Doctor’s Unavailable?

Although your physician may have set a due date, that is only a best guess as to when you will actually deliver.  Normally, your doctor will try to be available for a delivery in the week before and after that date.  However, extenuating circumstances or a very early delivery could cause them to be unavailable when you need them.  Instead of panicking when the time comes and taking whoever happens to be available, plan for this situation ahead of time.  Speak with your doctor about potential back-ups.  Ask who they recommend and if you can get their numbers for your on-call list.  It might also be a good idea to meet them, so if they do end up delivering your baby, you will have already established a relationship with them, making for a more comfortable experience.

 Who Can Come with Me?

Back in the day, women would bear their pain alone but for the doctors and nurses in the delivery room, but now, most moms want to bring in the father, or at least some trusted family member or friend.  For a standard delivery, this shouldn’t be a problem, but if there are complications, they may be asked to leave so that doctors have more room to work.  Normally, they will ask you to restrict access to the delivery room to one or two people and with all the chaos birth can bring, you’ll appreciate not having too many people around.  If you will be having a C-Section surgery though, having someone in the delivery room may or may not be possible.  Be sure to ask before promising access to anyone.

 Will Someone Be There to Show Me?

Some women panic a bit after going through delivery and finally getting the chance to be alone with their new baby.  They suddenly realize that they don’t know how to change a diaper or that breastfeeding is harder than it looks.  Luckily, there are people on staff at the hospital who can guide you through your first attempts at these tasks.  They can give you tips to help you get your baby to latch for breastfeeding and show you the proper way to take care of their sanitary needs as well.  Ask your chosen hospital about who they have available to go through these questions with you once you have delivered.

If you have more questions, be sure to join me for my live webcast, Inside Information for Women, every Thursday at 1pm Eastern.  I can take your call and do my best to answer any burning questions you might have regarding your pregnancy, delivery, or women’s health in general.  In the meantime, if your due date is approaching, be sure to write down the questions you have, so you will remember to ask each one at your next pregnancy check-up.  That way, when your baby and body are ready to deliver, your mind will be ready too.


– Yvonne S. Thornton, M. D., M. P. H.


Pregnancy and Power? It’s About Time!

Thursday, July 26th, 2012

Although many of us have gone through a pregnancy and maintained a rigorous career at the same time, it’s not something you often see when it comes to Fortune 500 positions.  Really, you don’t see many women in Fortune 500 leadership positions at all.  With Yahoo’s hiring of Marissa Mayer as their new CEO though, they now have both and she’s getting a lot of media attention as a result.

When Yahoo made the controversial move to snag Mayer away from Google, it wasn’t her intelligence and obvious experience that made the media pounce on the story.  Instead, it was her pregnancy.  People just couldn’t understand why Yahoo would take on a pregnant woman to save their downward sliding company.  Obviously, their process for selection has been long and they’ve done their research regarding who has the ideas and skills necessary to turn their company around.  When their first pick got caught lying on his resume, they didn’t take long to convince Mayer to leave Google, their main competitor.

Some say that Mayer will not be able to devote the kind of time and energy needed to revive the company as she gets further into her pregnancy and especially during maternity leave.  It seems that these people have never met a modern woman.  Most American mom’s work 40 hour plus weeks and take care of two or three kids, all while performing well at their positions.  In fact, according to the Bureau of Labor Statistics, seventy percent of American women with children under the age of eighteen are earning a paycheck while raising their children.  It’s shocking to realize that Mayer is the first pregnant Fortune 500 CEO ever.  Why can’t a woman use her uterus and her brain at the same time?  Has it really taken us this long to get over female stereotypes, particularly those concerning pregnancy?  This is the ultimate in multi-tasking. I know for a fact that both career and family can be balanced in a successful way.  In fact, I feel that it is my family who gave me the strength to achieve success in the first place.  My second memoir, Something to Prove, chronicles that journey.  I’m sure the arrival of Mayer’s baby will only drive her even harder to realize her career goals and those of Yahoo as well.  As far as seeing a pregnant woman in such a powerful position, I’d say it’s about time!


– Yvonne S. Thornton, M. D., M. P. H.

Reversing the Biological Clock with Someone Else’s

Thursday, July 12th, 2012

Because so many women hold giving birth as one of their ultimate lifetime experiences, they don’t want to miss out on it because of infertility or the aging process.  Unfortunately though, as women get older, their ability to reproduce decreases.  With so many American women waiting until later in life to start their families, these upwardly mobile women are finding problems with fertility issues to be more common than they had expected.  For this reason, doctors have been working on adding to their various fertility treatments to help these older women give birth.  In vitro fertilization is one method that has gained a new strategy that seems to be reversing the biological clock of women over 40 years of age.

For women who are 43 years or older, the likelihood of getting pregnant, even with the help of three cycles of in vitro fertilization, is only 10 percent.  This is because a woman is born with all the eggs she will ever have and over time, the number of eggs of a woman significantly decreases from 1 million at her birth down to 34,000 at 36 years of age.  Not only are there less in numbers but the likelihood of the remaining eggs to function normally in the reproductive process becomes less.  However, researchers have found that when one uses a “donor” egg, i.e.,  when a young woman’s eggs are donated and in vitro fertilization is used in combination with these younger eggs, the chances of pregnancy increase to 60 or even 80%.   Nearly 250,000 women participated in this reproductive study by researchers at the Baylor College of Medicine and what they found was quite promising.  Even infertile, older women using donated eggs and in vitro fertilization had the same chances of getting pregnant as fertile young women using natural means.

Although these findings are exciting for those desperate to have a baby later in life, the process is not as easy as it sounds.  It is an expensive, unpleasant process, and not without its drawbacks.  It’s important to remember that the baby is not genetically related to the mother.  Some women find that less appealing (to be carrying a child that does not have her DNA).  Moreover, sometimes infertility is a sign of other reproductive problems that can cause issues during a pregnancy and long-term concerns for a child born in this manner.  For this reason, it is extremely important to consult with your OB/GYN before proceeding with such a program.  Many “older” celebrities have become mothers in this fashion.  But, keep in mind, healthy babies come from healthy mothers, so one should consider all other options before traveling down this path to motherhood.

You can read more about infertility in the chapter, “I’m not pregnant—and I want to be” in my health book, “INSIDE INFORMATION FOR WOMEN”.


– Yvonne S. Thornton, M. D., M. P. H.



Sunday, June 17th, 2012

Daddy—Donald E. Thornton (1925-1983)

Happy Father’s Day!   It has been 30 years since my Dad passed away at 57 years of age.  He was too young to die, but there is not a day that goes by that I don’t think of him.  There are so many instances in which I say to myself, “What Would Daddy Do?”.  The answer to that question often solves the problem immediately!!  He was a humble man, an honorable man, and a person who saw the future for his five daughters (when no one else did).  With his prescience, he guided me and my sisters to careers virtually unheard of when I was a child.  Women as doctors?!  Black women as doctors?!  What a hoot!  Impossible!!

Yet, with his vision, persistence, love and determination, we realized his dream for all of his daughters becoming physicians (doctors).  That lofty goal was achieved over and over again in my family and is chronicled in my two memoirs, “The Ditchdigger’s Daughters” and “Something to Prove”.  Long before his dream for us to become doctors, he took it upon himself to get us out of the housing projects of New Jersey and build our home (with our Mom serving as his hod carrier).  He was a genius.  Daddy was a cross between Bill Cosby and Rocky. His indomitable spirit has lived on in each one of his daughters.  Although, we did not all become physicians, in one generation, he spawned two MDs, one oral surgeon (DDS), and one attorney (JD) and PhD., and the remaining living daughters of Donald and Itasker Thornton are all doctors.

He and my mother were a formidable team and great parents, as well.  I have fashioned my parenting skills after both of them.  Because they were lovingly strict, I have benefited from their life lessons and have taught my children those same lessons.  Education was revered in our family and it was our only way to get out of poverty and enjoy the mainstream world of privilege and success.  My son, is a physician and my daughter is a well-educated woman with Columbia and Stanford degrees.

I owe it all to my Dad (and Mom) who supported us, loved us, sacrificed for us and gave us a chance to succeed.

Yvonne S. Thornton, M. D., M. P. H.

May You Rest In Peace