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If you think sore nipples are just a normal part of breastfeeding, think again. Robin Hollen, APRN, and Breastfeeding Medicine Specialist, says that nursing can be an enjoyable experience for mom and baby without pain and discomfort. A top concern of nursing moms within the first week after delivery is how to prevent sore nipples. Even moms who’ve nursed before struggle with this common issue. While many women think it is a regular part of the nursing experience, it is actually a sign that something isn’t quite right. “Nursing your baby should be enjoyable,” says Robin Hollen, Breastfeeding Medicine Specialist with Renown Health. For over 30 years Robin has been supporting moms to breastfeed. Below she shares some valuable information and tips, helping you create a happy and healthy breastfeeding experience for you and your baby. What causes sore nipples? The most common cause of sore nipples involves incorrect latching. For a proper latch, a baby’s mouth takes in the entire nipple and some of the breast, so that the nipple rests at the back of the mouth where the palate is soft. With an improper latch, the mouth may slip down to the tip of the nipple while the baby nurses. This constant pressure on your sensitive skin may cause discomfort and pain. A board-certified lactation consultant can help assess if your baby is latched correctly and troubleshoot your breastfeeding concerns. Less common causes of sore nipples include: • Improper tongue placement of baby • Clenching • Incorrect breast pump use How can a mother prevent sore nipples from an improper latch? Breastfeeding is a learning experience for both mom and baby. Ask for help with the latch so your baby learns it correctly and maintains its depth. In the past, new mothers were surrounded by a community of women — their own mothers, grandmothers, or other family and friends — to provide assistance and guidance with every latch at the beginning of an infant’s life. In today’s culture, new moms can find themselves on their own with no extended family to lend their knowledge. Nurses, pediatricians and lactation consultants now fill that role; they are the eyes and hands along with the much-needed experience to guide new mothers. Our Breastfeeding Medicine experts assist nursing moms with latch every day. Even a single visit with a lactation consultant observing your breastfeeding baby can provide valuable insight on achieving, and maintaining, the proper latch - preventing future nipple soreness and discomfort. How to heal sore nipples from breastfeeding To heal sore nipples, you must first fix the cause, and correcting the latch prevents further damage. A lactation consultant can also help you address the pain. Below are some breast healing tips: • Your own expressed breast milk is excellent to rub into the nipple for anti-bacterial protection. • For those moms who need more lubricant or fat than breast milk offers, use a lanolin or a cream that is labeled safe for the baby. • Soothies are a gel pads providing comfort in between feedings, but should not be used with lanolin products. • Breast shells, not to be confused with shields, can guard the nipples from irritation or pressure in between feedings. If you have more questions about preventing and healing sore nipples or general breastfeeding concerns, talk to your pediatrician or a Renown Health Breastfeeding Medicine specialist at 775-982-6365.

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According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new sexually transmitted infection (STI) cases in the United States each year, with rates continuing to increase.  What you may not know is most STIs are preventable. We talked with Renown Adolescent Medicine Specialist, Caroline Barangan, MD to learn more about STIs.  How Can You Get an STI?  The CDC (Center for Disease Control) says that STIs are acquired through sexual contact. There are bacteria, viruses or parasites that can cause an STI which may pass from person to person in blood, semen, vaginal and other bodily fluids.  How Do You Know if You Have an STI?  STIs can have a range of signs and symptoms such as:  Warts, bumps or sores on or near the penis, vagina, mouth or anus Swelling, redness or severe itching near the penis or vagina Discharge from the penis Vaginal bleeding that’s not your period Painful or uncomfortable sex Vaginal discharge that has an unpleasant odor, causes irritation or is a different color or amount than usual  Weight loss, diarrhea or night sweats Aches, pains, fever and chills Jaundice (yellowing of the skin and whites of the eyes) Painful or frequent urination  Sore throat if you engage in oral sex It’s important to know that the majority of people who have an STI commonly have no symptoms at all, which is why it’s important to get regularly tested once you have had any sexual activity. Young people less than 25 years of age should be screened on a yearly basis at minimum.

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Breast milk. It's often referred to as liquid gold. And fortunately, it can be safely refrigerated or frozen for later use, which can allow you to be a bit more flexible in your new routine with baby. Whether you're getting ready to return to work, planning for the chance date night out or just exclusively pumping, it's crucial to understand the guidelines for proper breast milk storage. Storing Breast Milk Use clean bottles with screw caps, hard plastic cups that have tight caps or nursing bags (pre-sterilized bags meant for breast milk). Be sure to label each container with the date the milk was pumped and your baby's name if the milk is going to childcare providers. You can add fresh, cooled milk to milk that is already frozen, but add no more than is already in the container. For example, if you have two ounces of frozen milk, then you can add up to two more ounces of cooled milk. For healthy full-term infants, milk can be stored as follows: Room temperature - six to eight hours (no warmer than 77°F, or 25°C). Refrigerator - up to five days at 32°-39°F (0°-3.9°C). Freezer– Varies depending on freezer type. Up to two weeks in a freezer compartment located within the refrigerator. Three to six months in a freezer that is self-contained (standard kitchen fridge/freezer combination) and kept at 0°F (-18°C). Breast milk should be stored in the back of the freezer and not in the door. Six to 12 months in a deep freezer that is kept at -4°F (-20°C). Be sure to leave about an inch of space at the top of the container or bottle to allow for expansion of the milk when it freezes. Thawing Breast Milk Place frozen breast milk in the refrigerator to thaw (about 24 hours) then warm by running warm water over the bag or bottle of milk and use it within the next 24 hours. If you need it immediately, remove it from the freezer and run warm water over it until it's at room temperature. Never microwave breast milk and do not refreeze it. Once your baby has started to drink from the bottle, you should use it within one hour. You may find that different resources provide different recommendations about the amount of time you can store breast milk at room temperature, in the refrigerator and in the freezer. Talk to your doctor or lactation consultant if you have any concerns or questions.

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Becoming a parent for the first time means lots of new unknowns – from learning to breastfeed and swaddle to buckling your newborn into the car seat for the first time. But when it comes to putting them to bed safely, it’s important to remember it really can mean life or death. It’s something we’re taught before our little one is even here: the correct way to put your baby to bed safely. Sadly though, the number of infant deaths continues to climb. The main culprit of sleep-related infant death continues to be all the items parents leave in the crib with their babies. According to the Center for Disease Control and Prevention, there are about 3,500 sleep-related deaths among babies each year. “The best advice is ‘bare is best.’ Keep your infant’s sleep space clutter free – no blankets, bumpers, toys or pillows,” said Karen Wagner, Pediatric Nurse Practitioner. Follow the ABCs for Safe Sleep Remembering the ABCs is an easy way to remember how to put your little one to bed safely. A: Alone No blankets, toys or pillows. “We do recommend using a sleep sack as a blanket alternative,” said Karen. “It prevents the risk of suffocation and keeps your baby warm.” Keep in mind, the greatest risk for suffocation happens when babies are under 1 year of age, so it’s best to save the toys, blankets and pillows for their “big kid bed,” or around 18 months old. B: Back The slogan “back is best” is another good reminder. Keeping your baby on their back until they’re old enough to rollover helps reduce the risk of Sudden Infant Death Syndrome (SIDS). C: Crib It is best to have your baby sleep alone in their crib. While co-sleeping may be enticing, especially after a late-night feed, it increases the risks of possible suffocation. However, “having your child in your room, in their own crib or bassinet, is protective for SIDS,” Karen said. “In fact, we think co-rooming reduces SIDS risk by almost 50 percent.” Co-rooming allows parents to keep new babies in close reach and helps parents oversee their baby’s sleep, just in case something happens.

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Due to the stubborn nature of this year’s flu season, Hometown Health and Renown Health are adding additional flu shot events. Learn more about being protected and how to weather this year’s cold and flu season. Typical for this time of year, Renown is currently seeing a rise in patients with flu-like symptoms and other winter illnesses. To help protect the community, flu shots will be offered at the dates and times listed below: Friday, Feb. 23, 10 a.m. to noon Wednesday, Feb. 28, 5-7 p.m. Both flu shot events will be held at in the Hometown Health building located at 10315 Professional Circle, Reno NV 89521. These are walk-in flu shot events — no appointment required. No out-of-pocket costs for Medicare beneficiaries (Part B), Senior Care Plus members and Hometown Health fully insured HMO and PPO plans. Please bring your insurance card and current ID. Without a qualifying plan, the individual cost is $35. If you have questions regarding these flu shot events, please contact Hometown Health Wellness Services at 775-982-5433. And to help you weather the intense cold and flu season this year, we asked Kathleen Burns, an advance practice registered nurse at Renown Health, about flu prevention and how to know the difference between the flu virus and the common cold. How do you prevent the seasonal flu? The annual flu vaccine is truly the best form of protection to help prevent the spread of the flu. Even if you do get the flu after being vaccinated, your symptoms will be lessened. Flu vaccines are still available in the community, including health providers at Renown Medical Group. Call 775-982-5000 to make an appointment. Although they are not substitutes for the flu vaccine, simple preventative actions can do a lot to help slow the spread of the virus, including: Covering your mouth when coughing and staying away from people who are coughing. Washing your hands often. If you have the flu, stay home. If you have the flu and need to go out, including a visit to the doctor’s office, wear a protective mask. Other precautionary measures include cleaning shared spaces and avoiding shared utensils and drinks. Who should get the flu shot? Almost everyone. The Centers for Disease Control and Prevention recommends a yearly flu vaccine for everyone 6 months of age and older as the first and most important step in protecting against influenza. Different flu shots are approved for people of different ages, but there are flu shots that are approved for use in people as young as 6 months of age and up. Flu shots are approved for use in pregnant women and people with chronic health conditions. Bottom line: Your best chance of avoiding the flu this season is to get your flu vaccine. How do you know if it’s the flu or a cold? The flu and the common cold have similar symptoms and it can be difficult to tell the difference between the two. Your healthcare provider can give you a test within the first few days of your illness to determine whether or not you have the flu. In general, the flu is worse than the common cold. Symptoms such as fever, body aches, fatigue and cough are more common and intense with the flu. People with colds are more likely to have a runny or stuffy nose. Flu symptoms include: A 100 degree or higher fever or feeling feverish (not everyone with the flu has a fever) A cough and/or sore throat A runny or stuffy nose Headaches and/or body aches Chills Fatigue Nausea, vomiting, and/or diarrhea (most common in children) Does washing your hands really help prevent sickness like cold and flu? Yes. Again, the single best way to prevent seasonal flu is to get vaccinated each year, but good health habits like washing your hands often can help stop the spread of germs and prevent illnesses like the cold and flu. The proper way to wash your hands is to wet them with clean, running water (warm or cold) and apply soap. Lather your hands by rubbing them together. Be sure to lather the backs of your hands, between your fingers and under your nails. Scrub your hands for at least 20 seconds. If you need a timer, hum the “Happy Birthday” song from beginning to end twice. Rinse your hands well and dry them using a clean towel or air dry them. If soap and water are unavailable, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol to clean hands. Other good health habits include covering your cough; avoiding close contact with people who are sick; staying home when you are sick; and practicing a healthy lifestyle by getting plenty of sleep, being physically active, drinking plenty of fluids and eating nutritious food.

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Choosing Renown Women's Health is the first step to a healthy pregnancy. Our exceptional family-centered care with complete prenatal services is designed for the health and well-being of you and your baby. Board-certified primary obstetricians (OBs) coordinate pregnancy care and develop personal relationships with every mom-to-be, understanding birth choices and preferences. Labor & Delivery: 775-982-5759 Our specialties include: Managing high-risk pregnancies including twins, multiples, multiple miscarriages, history of previous premature births and diabetes Age 40+ pregnancies Pre-pregnancy medical conditions Infertility evaluation and treatments such as: Hormone treatments, fertility drugs and surgery

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