Gestational diabetes develops during pregnancy, typically between the 24th
and 28th weeks. Most women will experience some change in glucose levels during pregnancy due to fluctuating hormone levels. Gestational diabetes develops when glucose levels rise but a woman’s pancreas is unable to produce enough insulin to regulate
blood sugar levels. Developing gestational diabetes does not mean a woman was diabetic prior to her pregnancy, however approximately 20% of women with gestational diabetes will go on to develop type 2 diabetes later in life. Women with gestational diabetes
must make lifestyle changes to ensure their health as well as their baby’s.
Jacobson, MD, Obstetrics/Gynecology, discusses when women should be screened and what changes an expectant mother should make after diagnosis:
Women are screened for gestational diabetes approximately 24-28 weeks into pregnancy. However, women who
are at a higher risk for developing gestational diabetes—risk factors such as obesity, previous instance of gestational diabetes, family history of diabetes—will likely require earlier screening.
It’s important to keep gestational
diabetes in check to prevent complications that could affect your baby, such as excessive birth weight, increased risk of cesarean section, increased risk of birth trauma, premature birth, low infant blood sugar at birth, and an increased risk for type 2 diabetes
and obesity later in life. Left untreated, gestational diabetes can also result in a baby’s death.
Have questions about gestational
diabetes or advice to offer other women newly diagnosed with gestational diabetes? Join our new online community The Parent 'Hood to start a conversation today. Click here to
find out more.
Many women know what to expect during pregnancy but do you know what changes could be in store
for your body after your bundle of joy has arrived? Whether you’re wondering how long to wait before engaging in exercise or sex again, or if pelvic prolapse surgery might be right for you, find the answers here.
Roger Goldberg, MD, Director of the Division of Urogynecology at NorthShore and author of “Ever Since I Had My Baby,” answers “Body After Baby” questions.
Is moderate pain, like a pulling sensation,
normal in a c-section incision site after the incision itself has healed? Certainly any abdominal incision—including cesarean—can cause certain symptoms that are slow to fully resolve. This can include pulling or even sharp
pain on occasion. The likelihood of any serious issue with the symptoms you describe are small, and symptoms like these typically linger for awhile and then fade on their own. Certainly if this or any symptom continues or gets worse, happens frequently, or
disrupts your quality of life, have your surgeon re-check the area.
Are there things a woman can do prior to or during labor to minimize tearing and nerve damage, and improve and/or speed recovery?
There are. Here are some
After childbirth, there is the option of pelvic floor physical therapy. We work closely with our physical therapists
here at NorthShore, and they're a great resource for rehabilitating muscles and tissues that have undergone change due to pregnancy and childbirth
How long after pregnancy and labor should you wait to exercise? There's
not a great deal of science to "prove" the right answer to this question. Assuming you are feeling well, walking and general aerobic activity can usually be resumed around four weeks for your overall health and well being. However, I would be concerned about
heavy weightlifting, excessive squatting and high-impact activities at a time when pelvic tissues are still recuperating. The pelvic tissues in terms of strength and tone look very different at one month postpartum compared to three months postpartum. As a
doctor and surgeon who deals regularly with women that have prolapse symptoms, I would recommend to err on the side of caution by waiting three months postpartum for high-impact activities. Always check with your obstetrician to be sure.
pain during sex normal after childbirth? How long could pain last? What remedies are there? The perineum (tissues between the vagina and rectum) can be very tender after childbirth. Some patients require more time, some require less, for
pain to resolve. Studies have shown that roughly 25% of women will still have some sexual complaint at six months after “normal” vaginal birth. The good news is that many of these resolve spontaneously with time and patience.
If the area
is extremely tender, check with your physician because in rare cases, a quick surgical revision may be required; however, for most, pain subsides with time, patience, lubrication and perhaps some estrogen cream.
When should you be concerned
about pain after childbirth?I want to emphasize that pain is not normal if it doesn't slowly but surely resolve on its own. If you're getting better and the pain is disappearing, there isn’t a problem; however, if you're
experiencing worsening or persistent pain in the pelvic area, consider seeing a urogynecologist for a basic evaluation.
Is it normal to leak urine when coughing or sneezing? This is called stress incontinence, and it's
reported to some degree by up to 50% of post-childbearing women by age 40. While it is common, it’s not normal and not something you must simply accept. Fortunately, stress incontinence is amazingly treatable.
When would you recommend surgery for pelvic prolapse? How long is the recovery after surgery?
This is a personal decision for every woman. It’s important to note that there is rarely a medical reason to rush the decision. Minimally invasive surgical options are available, so some women opt for surgery rather than trying non-surgical methods.
I perform 95% of surgeries without any abdominal incision, the majority of cases take less than an hour and many involve no hysterectomy. This has translated into a quick recovery for most, but, we always need to acknowledge that recovery can be slower
than expected for some. In my current practice, nearly all patients go home the next day, use pain medication for only a short of number of days.
My overall advice is that if you're considering surgery, the most important factor is that your
surgeon has a lot of experience with the technique being performed. Part of the reason we believe our patient outcomes are so strong here at NorthShore is that we're committed to being the experts in these areas.
Have questions about
recovery following childbirth or advice to offer other new moms? Join our new online community The Parent 'Hood to start a conversation.
Parents, it starts with you. You are the first and most important
influence on the current and future health of your children. The example you set could put your children on a course for a lifetime of healthy living, especially when it comes to heart health. The health risks posed by a sedentary lifestyle, poor diet and
obesity are immediate because heart health matters at any age, even in young children.
Najman, MD, Cardiology at NorthShore, shares some easy ways that parents can set a heart-healthy example for their children while also improving their own health:
Healthy diet. If you want your children to eat fruits and vegetables,
you need to set the example by eating fruits and vegetables yourself. Include your children in the decision making and help guide them by discussing the benefits of the delicious fruits, vegetables and whole grains that you will eat together as a family
every night. If children grow up eating healthy foods together with their parents, eating those same foods as young adults and adults won’t feel strange or difficult at all; those same foods will be what they ate growing up.
Show your children that exercise is important by maintaining a regular workout routine. And, as often as you can, get every member of the family involved in a fun, physical activity. Jog together as a family; ride bikes together as a family; go on a brisk
evening walk together as a family. Children experience the same health benefits of exercise as adults—strong bones and muscles, maintenance of a healthy weight, lower blood pressure and cholesterol, and a regular exercise routine reduces one’s
risk for heart disease, diabetes, some cancers and more. Get your kids moving now and they will likely maintain that active lifestyle later in life. Lead by example!
Smoke-Free. If you quit smoking, your kids are less likely to start.
Smoking is more common in teenagers whose parents smoke. If you are still smoking, quit. Secondhand smoke is linked to lung cancer but it also increases the risk of multiple types of cancers, heart disease, diabetes and many other medical issues as well.
Maintain a healthy weight. Today in the U.S., one child out of three is considered obese or overweight. Type 2 diabetes and high blood pressure, once common health issues encountered only in adulthood, have developed in children as young
as seven. Obese children are also more likely to become obese adults, increasing their risk of developing heart disease later in life. Don’t focus on weight with children; instead, shift to leading a healthy lifestyle as a family. Lifestyle changes
like eating right as a family and exercising can make all the difference.
What do you do to set a heart-healthy example for your children?
Measles is extremely contagious, infecting nearly 90 percent of unvaccinated people who come into
contact with it. Why is it so contagious? It’s spread through the air (via coughing/sneezing). People standing in the airspace around the infected person can become infected by breathing in these respiratory droplets; they do not need to be sneezed
or coughed on directly. Those infected with measles are at their most contagious the four days prior to the appearance of the rash, meaning they are extremely contagious before they themselves are aware of the virus.
Measles symptoms develop
approximately 8-12 days after exposure but the measles rash will not develop until 3 -5 days after symptoms first appear. The first symptoms are similar to a severe cold:
The measles rash begins on the face but quickly spreads downward, covering the body. Fever may be at its highest—topping 104 degrees Fahrenheit—at
the appearance of the rash.
Before the measles vaccine, more than three to four million people in the U.S. would contract the virus each year. Infected individuals can develop mild-to-severe complications including pneumonia, blindness, deafness,
brain swelling, permanent neurological damage and even death.
Julie Holland, MD, Head of General Pediatrics at NorthShore,
discusses who should receive the MMR (measles, mumps and rubella) vaccine and when:
Everyone should be vaccinated. Vaccines like MMR are a safe and effective way to prevent the spread of the virus. While there have been small outbreaks in the
U.S., measles is very common in other parts of the world and can spread easily to the unvaccinated and under-vaccinated in the U.S.
Make an appointment or call your doctor or your child’s pediatrician
to ensure you and your children are adequately vaccinated.
Life can be hectic, especially the life of a parent, which is why we hope to provide our community
members with a place to find the answers they need. NorthShore’s new community is an online destination for parents to share their experiences and support each other, as well as connect with our team of medical experts, from obstetricians to pediatricians.
Carl Buccellato, MD, OB/GYN at NorthShore, and an active expert member of the community, says, “I hope my experience both as a physician and a parent will be a resource for expecting parents” of the Parent ‘Hood.
community will cover a variety of topics, from pregnancy issues like gestational diabetes and nutrition to parenting topics like how best to address your toddler’s tantrums and childhood vaccinations. You can join the conversation now!
conversations:Toddler Tantrums Itchy and PregnantPost-Partum Hair Loss
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Every parent has been there at one point or another—at the mercy
of his or her child’s tantrum in the checkout line at the grocery store, in a crowded restaurant or at home. In a matter of minutes, your child goes from quiet and well-behaved to completely inconsolable.
The good news is
that temper tantrums are entirely normal, especially in toddlers. For toddlers, tantrums are often brought on by a young child’s inability to understand and cope with his/her emotions, emotions related to hunger, tiredness or feeling overwhelmed and
While it’s not possible to prevent every single emotional meltdown, there are ways to manage them. Leslie
Deitch Noble, MD, Pediatrician at NorthShore, discusses some of the best techniques for approaching tantrums:
Don’t overschedule. Try not to overexert your child by packing too much into the daily schedule. This
is not to say that every day needs to be the same, but when possible try not to push your child to the limits with errand running. A hungry or tired child is much more likely to act out. If you know you have a long day ahead, let your child know in advance
so he or she will be better prepared for the change of pace.
Be consistent with your approach. Try your best to manage your child’s behavior during every tantrum. Encourage communication during a tantrum. Say, “Use
your words” or ask clear questions to better understand what might be causing your child’s frustration. Lastly, do not give in. Letting your child have his or her way during a tantrum won’t help break the cycle, even if it ends the immediate
tantrum. Ideally, you don’t want to give your child any attention—positive or negative—while he or she is having a tantrum. So, as long as you are not in public and your child is not going to hurt him or herself, the best approach is to completely
ignore your child until the tantrum stops.
Distract. Distract. Distract. If you can, try to divert your child’s attention away from what may have prompted the tantrum in the first place. Be sure that you recognize that
he or she maybe be upset by a situation, but then offer different options or new activities. For example, if your child has a tantrum over wanting a new toy or treat at the store, you can suggest that you find the “new” toy she got most recently
when you go home. A similar approach can be tried with treats. If necessary, try to avoid going down aisles at stores that might prompt meltdowns.
Celebrate (and embrace) the good times. Let your children know when they are
behaving well and encourage this type of behavior. Tell them how happy it makes you when they listen and follow the rules. Along with acknowledging good behavior (and even rewarding it), be sure your children know how much you love and care for them. Much
of what triggers tantrums is children wanting to express their emotions and wanting attention.
Have questions about tantrums? Get answers from other parents and our team of experts in our new online community The Parent 'Hood.
Find out more here: The Parent 'Hood.
There is no magic age for when it’s best to transition your toddler from a crib to the “big-kid”
bed. Much of the timing depends on your child’s readiness as well the need to free up the crib for a new little brother or sister. In most cases, toddlers transition to a bed between the ages of 18 months to 3 years.
Whether you are mid-transition
or only in the planning stages, Susan Roth, MD, Pediatrician at NorthShore, offers helpful tips to make the change a smoother one:
Have questions about transitioning your toddler from a crib to a bed? Join NorthShore's new online community, The Parent 'Hood, to ask and answer questions as well as connect with
our team of medical experts. Check it out here.
For exhausted new parents, it can be a relief when your infant finally settles down to sleep for the night
(or even just a couple of hours) but there can be fear as well. Sudden Infant Death Syndrome (SIDS) can happen even when all the right safety measures are practiced. The exact cause of SIDS is unknown. SIDS is most common in infants less than
six months of age but can occur between one month and one year.
While nothing can prevent every case, there are ways to significantly reduce the risk of SIDS. William MacKendrick, MD, Neonatologist at NorthShore, shares safe sleeping recommendations every parent should practice:
Have your own questions about safe sleeping or another parenting topic? Join the conversation in our new online community:
The Parent 'Hood.
Hand, foot and mouth disease (HFMD) is a typically mild but highly contagious
viral infection most common in children under seven years of age. The illness is characterized by mouth or throat pain (due to sores), fever and a rash (typically involving the hands, feet, buttocks, arms and legs). The infection is caused by enteroviruses—most
often coxsackie virus A16—which are transmitted from person-to-person by oral contact with stool, saliva, fluid from skin lesions or respiratory fluids via coughs or sneezes. Herpangina, also caused by enteroviruses, is a cluster of symptoms characterized
by fever and mouth lesions (but no rash). These illnesses are particularly common in child-care settings because of the frequency of contact and germ sharing between children and inadequate handwashing—especially after diaper changes or toilet
use. The viruses can also be transmitted by contact with contaminated surfaces or objects, like toys.
Outbreaks occur most often in summer and fall but can happen anytime, especially if your child is in daycare. Kenneth Fox, MD, Pediatrician at NorthShore, shares symptoms parents should watch for and outlines ways you can make your child more comfortable while the virus runs its course:
Symptoms of Hand, Foot and Mouth Disease:
Symptoms of Herpangina:
Fever and mouth/throat pain usually last three to five days. Other symptoms, like mouth sores and rash (with HFMD)
can last up to seven to ten days. The virus is shed orally for one to three weeks and in stool for two to three months after infection. While there are no cures for HFMD or herpangina, there are things you can do to make your child more comfortable during
those first few days, as well as reduce the risk for dehydration which can occur because of pain and difficulty swallowing.
What can parents do?
Keep little ones hydrated. Try Pedialyte or Gatorade to keep
their electrolytes up. Also popsicles, ice chips and other frozen treats can replenish fluids while also helping with pain.
Reduce pain or fever. Use Acetaminophen or Ibuprofen but check age-appropriate dosages before administering.
Make swallowing easier. Eliminate salty, spicy or acidic foods to avoid further irritating mouth sores. Consider providing a variety of soft foods, like yogurt, pudding and rice. And always rinse mouth after meals.
is not always possible to prevent your child from contracting hand, foot and mouth disease, you can reduce his or her risk, and your own. Here are some ways to keep your kids healthy and prevent the spread of HFMD in your home:
If your child does get hand, foot
and mouth disease, watch for these signs of complications:
Have questions about hand, foot and mouth disease or any other pediatric illness? NorthShore's new online community,
The Parent 'Hood, has answers. Join today to connect with other parents in the community as well as our expert physicans. Click here to start now.
For David Roberts, MD, Pediatric Orthopaedics at NorthShore, helping people was always the goal on the horizon,
which is what ultimately brought him to medicine. Once there, it was the challenge and the enjoyment of treating children that brought him to pediatric orthopaedics.
Here, he explains the ins and outs of his unique specialty
and how his experience as a father has informed the way he treats his patients and their parents:
What first attracted to you medicine? Was there something that inspired you to go
into the field? I chose a career in medicine because I wanted to help people. There wasn’t one specific moment of realization; it was always what I wanted to do with my life. Why did you decide to pursue pediatric orthopaedics as a specialty? I decided to become a pediatric orthopaedist during the middle of my orthopaedic surgery residency.
During my training, I enjoyed all different areas of orthopaedics so it was hard to pick just one area! Pediatric orthopaedics is unique in that you take care of a variety of conditions affecting all areas of the body, from fractures and congenital
anomalies, to scoliosis and spine conditions. It also covers a wide age range, from newborns to young adults. The diverse nature of pediatric orthopaedics is challenging but that’s also what I enjoy most
about it. And, of course, kids are fun.
What do you like most about your job? Seeing my patients get better. Often my patients are in pain or recovering from an injury when we first meet. Seeing them recover and get back to normal, being a part of that, is what I like best about my practice.
What do you find most challenging? Encountering overuse injuries in young athletes is difficult. Young kids are increasingly involved
in sports at "elite" levels, playing harder and longer than ever before. Overuse inevitably can lead to chronic and recurrent injuries of various types. Generally, the cure is simple—rest—but these
are some of the hardest conditions to treat given the pressure from coaches, teammates, parents and even the children themselves. Fortunately with time, rest and realistic expectations, these conditions typically
resolve and permit the child to fully return to activities.
What do you think is an essential skill of a pediatric orthopaedic surgeon? You have to really enjoy working with
children. Treating children is very different from treating adults. Children of different ages require different approaches at interview and examination, which represents the "art" of medicine. To be truly good at it this, you really have to like working with kids, and this is what I like most about my job.
How is treating orthopaedic cases in children different
from adults? Kids are not just little adults. From an orthopaedic perspective, treatment of children's conditions can
be drastically different than in adults, and not just because we have more cast colors to choose from.
Unlike adults, children's bones are still growing, which means they require special respect and consideration during treatment
for orthopaedic conditions. For example, fractures that typically require surgery for an adult may be treated without surgery in a child because of the ability to correct bone alignment over time with growth. Other injuries can potentially affect growth and require close monitoring over time for years after injury. Very young children also may require different treatment for
the same type of injury in an adult because a child may be too young to follow treatment instructions.
Within pediatric orthopaedics, you specialize in scoliosis. What inspired this interest? I specialized in scoliosis because of the positive impact surgery for this condition has on a patient's life. For many patients with severe scoliosis, the condition is more than just a curvature
of the spine. Severe curves negatively affects self-esteem and body image, which are already vulnerable during the teenage years even for those without scoliosis. After
surgery for scoliosis, these patients literally and figuratively stand taller and straighter. It can make a difference to the rest of their lives.
What are some of the biggest influences
on the way you treat your patients? My own experience as a parent has really informed my practice. Having a child gives you practical experience working with children but also the perspective of
a parent. I believe it is my duty to care for your child as I would my own.