Virtually nursing-in? Try nipple-soothing peppermint

If you plan to do some extra breastfeeding today as part of the great virtual breast fest, here's a tip from a recent study on preventing and soothing those nipple cracks that might arise.

Researchers studied whether peppermint gel, lanolin gel, or a neutral ointment were better for soothing the nipple pain and cracking that are often associated with first-time breastfeeding. They enrolled 216 women into the study and randomly gave them one of the 3 gels. They did not tell the women which gel they received, but they did tell them to use the gel daily for the first two weeks of breastfeeding. They found the peppermint gel was much more effective than either lanolin or a neutral ointment in reducing the rate of nipple and areola (the area around the nipple) cracks and pain.

Sore nipples are a common reason some women fail to continue breastfeeding in the early days of trying. However, breastfeeding is so beneficial to moms and babies that women's health researchers will take time to figure out how to keep mom comfortable while she and her infant learn to feed.

Now if we could only figure out how to keep the general public feeling comfortable when they see a mom breastfeeding....

Panic attacks possibly linked to heart disease and death

If you've ever had a panic attack, this headline may not surprise you. Many of the symptoms of panic attacks can mimic a heart attack: racing heart, chest pain, sweating, nausea, dizziness, and shortness of breath. These symptoms usually peak within 10 minutes, and they can be accompanied by fear of leaving home. Approximately 1 in 75 people experience panic disorder, and it is more common in women than men.

Researchers investigated the relationship between panic attacks and heart disease in a study of nearly 3,400 postmenopausal women. They found that women who had experienced a panic attack in the previous 6 months were four times as likely to have heart disease, and three times as likely to have a stroke. These women also were 75% more likely to die from heart attacks and stroke.

If you are in this population of women (i.e., a postmenopausal women who has been diagnosed with panic disorder or who has experienced panic attacks), these findings may seem worrisome. However, it is important to note (as the investigators do) that the number of women who actually had an event (i.e., heart attack, heart-related disease, or stroke) was extremely small - only 81 women, or 2.5% of the those studied. Still, it is something to discuss with your doctor, who may recommend additional tests to evaluate your heart and vascular health.

Meantime, also know there is treatment for panic disorder. Anti-anxiety medications and cognitive behavioral therapy can help to alleviate the symptoms and improve your quality of life.

Pregnancy weight gain - one size doesn't fit all

Most women know about the traditional weight gain recommendations for pregnancy: 25-35 pounds if you're normal weight (body mass index = 20-25), up to 10 pounds more if you started the pregnancy underweight (BMI <> 25). However, a new study published this week in Obstetrics & Gynecology suggests that these guidelines may be out of date, at least as far as obese women are concerned.

Investigators analyzed data from more than 120,000 obese women in Missouri to see how the weight they gained during pregnancy affected three outcomes: blood pressure, rate of cesarean sections, and the infant's birth weight. They found that 23% of obese women gained less than 15 pounds, 31% gained the recommended 15-25 pounds, and nearly 50% gained more than 25 pounds. The women who gained less weight during pregnancy had the best outcomes, including less pregnancy-induced high blood pressure and normal weight babies.

The researchers also calculated optimal ranges of weight gain during pregnancy based on pre-pregnancy BMI. Women with BMIs of 30-34.9 had the best outcomes when they gained between 10 and 25 pounds. These same women were more likely to have low birth-weight babies when they lost weight, but they had fewer other complications like high blood pressure and C-section deliveries. Women with a BMI of 35-39.9 did best when they gained less than 9 pounds. For women with a BMI of 40 or higher, losing up to 9 pounds produced the best outcomes.

As you can see, this study's findings contradict the current guidelines, which were established in 1990 when obesity wasn't so common. However the current guidelines may be no more. The Institute of Medicine plans to reevaluate its recommendations for weight gain during pregnancy to reflect more recent evidence about pregnancy and birth outcomes.

What does this mean for you? If you are obese and pregnant, or planning to become pregnant, talk to your doctor or midwife about the best weight gain - or weight loss - strategy. And remember, no matter what weight you are, it's important to eat a nutritious and well-rounded diet while pregnant and postpartum.

'Tis the season - flu season that is

Monday, October 1st marks the official start of flu season. While anyone can get the flu vaccine if they want to reduce their chances of getting the flu, the Centers for Disease Control recommends some groups of adults get vaccinated every year, because they are at increased risk for severe complications if they do become sick. These groups include:

• Women who will be pregnant during flu season
• People who have weakened immune systems, such as from HIV/AIDS, chemotherapy, organ transplants, or autoimmune disorders (e.g., multiple sclerosis, rheumatoid arthritis)
• People who have chronic health conditions, such as heart problems, lung disease (e.g., asthma, emphysema, bronchitis), diabetes, and kidney disease
• People 50 years and older
• People who work in a health care setting or family members of those in high risk groups

For the folks noted above, you unfortunately have to get vaccinated with an injection (this is the inactive, or "killed," form of the virus). However, if you are a healthy adult under age 50 who is not pregnant, you can avoid the needle. FluMist is a nasal spray vaccine that will spare you the shot.

The best time to get vaccinated starts Monday. October and November are the recommended months to provide the best chances for keeping the bug away. However, you still may receive some benefits if you get vaccinated in December or later. And remember: it takes two weeks for full immunity to develop, so plan ahead. (You never know when there's going to be another vaccine shortage.) Call your health care provider for an appointment or find a flu shot clinic near you today.

PMS: You are what you eat - or something like that

Periods are bad enough without adding premenstrual agonies to the front end. You know what I'm talking about - the bloating, breast tenderness, irritability, fatigue, acne, crying spells, anxiety, and food cravings (chocolate, salt, both - do I hear chocolate covered pretzels anyone?) that occur a week or so before your period arrives.

There has been a lot written in the popular media about easing PMS symptoms through changes in diet, such as consuming less caffeine and sodium and increasing vitamin B intake. But a study published in the Journal of Women's Health actually looked at what proportion of the participants' diets consisted of what kinds of foods (e.g., fats, carbs, fiber) and how these proportions related to their premenstrual symptoms. The study consisted of 3,302 ethnically diverse women who participated in SWAN (Study of Women's Health Across the Nation). They did find some relationships between what women ate and how they felt. But you may be surprised by the results (I sure was).

Fat intake was associated with fewer premenstrual cravings and less bloating (potato chips okay). Caffeine was associated with more anxiety and mood changes (pumpkin spice latte from Starbuck's not okay). Alcohol consumption was associated with less anxiety and mood changes (glass of red wine okay), but more headaches (or maybe not okay). Fiber was associated with more breast pain (bran muffin maybe not okay, I'm still not sure about this one - see below).

Perhaps more important than the dietary findings, they found certain subgroups of women experienced PMS differently. Perimenopausal women reported significantly more premenstrual symptoms than premenopausal women. Additionally, women with depression reported more PMS symptoms, especially anxiety and mood changes. Conversely, 0lder women reported less anxiety, mood changes, and back pain. Finally, overweight and obese women reported more cravings and bloating than normal weight women.

Is there a dietary moral here? The authors of the study say no. With the exception of caffeine, most of the dietary relationships were in the opposite direction - that is, fat and alcohol were actually associated with fewer symptoms, not more. Additionally, I would add there are other benefits of fiber intake that may outweigh the monthly nuisance of breast pain (although I'm not someone who experiences breast pain, so I might be convinced otherwise). They also didn't time their study to measure food intake and then track subsequent symptoms in the same 2-week period. Had they done this, they might have identified some different relationships between food and symptoms. Perhaps the more important part of this study is the identification of subgroups of women who are at higher risk for PMS symptoms, namely perimenopausal women, overweight women, and women with depression. If you are in one of these subgroups and you experience PMS, talk to your health care provider about ways to alleviate your symptoms.

Improve depression with exercise

Exercise produces a lot of benefits. It reduces the risk of stroke and heart disease. It lowers the "bad cholestrol" while increasing the "good cholesterol." It helps to reduce blood pressure and maintain a healthy weight. According to research published online this month in Psychosomatic Medicine, exercise is also an effective treatment for depression.

Researchers tested the effectiveness of 4 types of depression treatments: a led exercise regimen, a home exercise program, an antidepressant known as a selective seritonin reuptake inhibitor (SSRI), and a placebo, or a pill that does not contain any medicine. They sorted 202 adults (153 women) with depression into each of the groups and followed them for 4 months.

They found that 41% of all patients no longer met the criteria for major depressive disorder. When they broke the groups down by treatment group, they saw improvements in all 4 groups. Secifically 45% of the led exercise group, 40% of the home-based exercise program, 47% of the antidepressant group, and 31% of the placebo group saw improvements. Interestingly, the rates of improvement were very similar for those in the led exercise group and those taking antidepressants. Further, although participants in the 3 "active" treatment groups (led exercise, home exercise, and antidepressants) had greater improvements than the placebo group, nearly one-third of those in the placebo group still got better. The investigators noted that improvements in depression may be related to factors other than treatment type, such as attention from mental health care providers and monitoring of symptoms.

Per the investigators, it is important to note that this study does not demonstrate that exercise is better than SSRIs for relieving depression. So if you are taking antidepressants, this is not license to stop your medication without first discussing the pros and cons of such a decision with your doctor. However, the study authors d0 note that exercise can increase positive thoughts, enhance self-concept, and change how the body responds to stress, all of which can lead to fewer depressive symptoms. So if you have depression or are prone to a depressed mood, try some exercise - you might see improvements in your mood, as well as other areas of your life.

In your face(book): Calling all breastfeeding moms

As noted in the description of this site, my purpose is to relay research findings in a way that is more accessible to women who are not researchers themselves. However, occasionally something comes to my attention that is not research per se, but supports what research shows is a positive health behavior.

Today that something is breastfeeding - or more specifically, a breastfeeding event sponsored by the League of Maternal Justice. As I have discussed before, breastfeeding is healthy for babies AND moms for a variety of reasons. These mothers have united to support not only the act of breastfeeding, but the right to breastfeed undisturbed in a public venue, and the right to not be censored on a social media site for showing yourself breastfeeding.

So if you are (or have been) a breastfeeding mother, you can participate in this event on October 10th at 10AM. Check out the website for more details.