September 25, 2016


1. Intermenstrual spotting

Approximately 50% of people using the pill experience vaginal bleeding between expected periods - also known as breakthrough bleeding - most commonly within the first 3 months of starting to take the pill. Generally, this resolves in over 90% of cases by the third pill pack.

During spotting, the pill is still effective as long as it has been taken correctly and no doses were missed. People who experience 5 or more days of bleeding while on active pills or heavy bleeding for 3 or more days should contact a health care professional for advice.

Intermenstrual spotting may occur due to the uterus adjusting to having a thinner endometrial lining, or maybe due to the body adjusting to having different levels of hormones.

2. Nausea

Some people experience mild nausea when first taking the pill, but symptoms usually subside after a short period of time. Taking the pill with food or at bedtime can help lower the likelihood of nausea. Anyone experiencing persistent or severe nausea should seek medical guidance.

3. Breast tenderness

Birth control pills may cause breast enlargement or tenderness. This side effect tends to improve a few weeks after starting the pill, but anyone who finds a lump in the breast or who has persistent pain or tenderness or severe breast pain should seek medical help.

Reducing caffeine and salt intake can decrease breast tenderness, as can wearing a supportive bra.

4. Headaches

The sex hormones have an effect on the development of headaches and migraine. Pills with different types and doses of hormone may result in different headache symptoms. Some studies have previously suggested that headaches are least likely to occur with pills that contain low doses of hormones.

Headache symptoms are likely to improve over time. Anyone who experiences new onset of headaches when taking the pill should seek medical attention.

5. Weight gain

Clinical studies have found no consistent association between the use of birth control pills and weight fluctuations. However, many people taking the pill report experiencing some fluid retention, especially in the breast and hip areas.

Fat cells can also be affected by the estrogen in birth control pills, although the hormone causes the cells to become larger rather than more numerous.

6. Mood changes

People with a history of depression are recommended to discuss this with their medical provider, as some people do experience depression or other emotional changes while taking the pill. Anyone experiencing mood changes during pill use should contact their medical provider.4

A study of 90 women published in Human Mapping in 2015 found that use of the birth control pill was associated with smaller cortical thickness measurements in the lateral orbitofrontal cortex and the posterior cingulate cortex. These areas of the brain are linked with reward response and evaluating incoming stimuli.

The authors of the study write that further research needs to be conducted to confirm whether or not there is a connection between cortical thinning in these areas of the brain, mood changes and birth control pill use.

7. Missed periods

There are times when, despite proper pill use, a period may be skipped or missed. Several factors can influence this, such as stress, illness, travel, and hormonal or thyroid abnormalities.

If a period is missed or is very light while on the pill, a pregnancy test is recommended prior to taking the next pack of pills; if further periods are missed or are very light, seek medical advice.

8. Decreased libido

The hormone(s) in the contraceptive pill can affect sex drive (libido) in some people. However, many other factors can contribute to a decrease in libido. If decreased libido persists and is bothersome, this should be discussed with a medical provider.4

In some instances, however, the birth control pill can increase libido. Such an increase may be due to the relief of painful symptoms such as menstrual cramping, premenstrual syndrome, endometriosis and uterine fibroids.

9. Vaginal discharge

Some people experience changes in vaginal discharge when taking the pill. This can range from an increase to a decrease in vaginal lubrication, an alteration in the nature of the discharge, and changes which can affect sexual intercourse. In the event of vaginal lubrication decreasing, added lubrication can be utilized to make sex a more comfortable prospect.

Typically, changes in vaginal discharge are not harmful. Anyone who is concerned about such changes, however, including those who suspect an infection, should speak with their medical provider.

10. Visual changes with contact lenses

Hormonal changes caused by the birth control pill can lead to fluid retention which, in turn, can cause the corneas to swell or change shape. When this swelling occurs, contact lenses may no longer fit comfortably.

Contact lens wearers should consult their ophthalmologist if they experience any changes in vision or lens tolerance during pill use.

September 19, 2016


-Blood-colored material mixed in with the stool, on the surface or passed separately
    -Blood in the stools is usually bright red
    -Blood from bleeding in the stomach comes out tar-black


    Anal Fissure: If no associated diarrhea, more than 90% of children with blood in the stools have an anal fissure. Anal fissures usually are caused by passage of a large or hard stool.
    -A Strep skin infection around the anus can also cause blood-streaked stools.
    -If associated diarrhea, most of the children have Shigella, Salmonella or Campylobacter infections.
    -Some foods (e.g., tomatoes or beets) and drinks (e.g., red Kool-Aid) and some medicines (e.g., amoxicillin or omnicef) can also cause red-colored stools that look like blood.

When to Call Your Doctor for Blood in the Stools


  -Your child has fainted or is too weak to stand.
  -Your child looks or acts very sick.
   -Large amount of blood, blood alone without any stool or the toilet water turned red
    -Tarry or black-colored stool (not dark green)
    -Blood with diarrhea
    -Pink- or tea-colored urine
    -Vomited blood
    -Abdominal pain or crying also present
    -Skin bruises not caused by an injury
    -Age under 12 weeks
    -Small bleeding occurs over 2 times
    -Followed an injury to anus or rectum
    -Blood in the stools, but none of the symptoms described above (Reason: probable anal fissure)
    NOTE: Try to save a sample of the "blood" for testing if your child needs to be seen.

Home Care Advice for Anal Fissure (Pending Talking with Your Doctor)

    Definition: An anal fissure is the number 1 cause of blood in stools.
        -The blood is bright red, but only a few streaks or flecks are present
        -All the blood is on the surface of the stool or on the toilet tissue after wiping
        -Usually follows passage of a large or hard stool
        -You may see a shallow tear at 6 or 12 o'clock on the anus
    Warm Saline Baths: Give warm saline baths for 20 minutes 2 times per day for 1 day to cleanse the area and to promote healing. Add 2 ounces (60 ml) of table salt or baking soda to a tub of warm water.
  Steroid Ointment: If the anus seems irritated, apply 1% hydrocortisone ointment (no prescription needed) 3 times per day for 1 day to help healing.
  High-Fiber Diet:
        For children more than 1 year old, offer a nonconstipating diet.
       -Increase fruits, vegetables and grains (fiber).
        -Reduce milk products to 3 servings per day.
        -If Constipation is definitely the cause, see that topic.
    Expected Course:
Anal fissures usually heal up quickly with home treatment.
    Call Your Doctor If:
   -Bleeding increases in amount
     -Small bleeding occurs over 2 times
        -Your child becomes worse
And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.

September 13, 2016


If your child’s urine has a red, orange, or brown color, it may contain blood. When the urine specifically contains red blood cells, doctors use the medical term hematuria to describe this condition.


Many things, including a physical injury or inflammation or infection in the urinary tract, can cause it.

Hematuria also is associated with some general medical problems, such as:
  -defects of blood clotting,         
-exposure to toxic materials,
-hereditary conditions,
-immune system abnormalities.

Sometimes there may be such small amounts of blood in the urine that you cannot see any color change, although it may be detected by a chemical test performed by the pediatrician.

In some cases the reddish color is not associated with hematuria at all, and the reddishness may be due simply to something your child has eaten or swallowed. Beets, blackberries, red food coloring, phenolphthalein (a chemical sometimes used in laxatives), or phenazopyridine (medicine used to relieve bladder pain), and the medicine rifampin may cause the urine to turn red or orange if your child ingests them.

Anytime you are not sure that one of these alternative explanations is responsible for the color change, call your pediatrician. Blood in the urine, when accompanied by protein (albumin), is usually due to inflammation of the filtering membranes of the kidney; the general term for this condition is nephritis. Your doctor may recommend further tests to distinguish among several different kinds of nephritis.


Your pediatrician will ask you about any possible injury, foods, or health symptoms that might have caused the change in urine color. He will perform a physical examination, checking particularly for any increase in blood pressure, tenderness in the kidney area, or swelling (particularly of the hands or feet or around the eyes) that might indicate kidney problems. He also will perform tests on a sample of urine and may order blood tests, imaging studies (such as an ultrasound scan or X-rays), or perform other examinations to check the functioning of your child’s kidneys, bladder, and immune system.

If none of these reveals the cause of the hematuria, and it continues to occur, your pediatrician may refer you to a children’s kidney specialist, who will perform additional tests. (Sometimes these tests include an examination of a tiny piece of kidney tissue under the microscope, a procedure known as a biopsy. This tissue may be obtained by surgically operating or by performing what’s called a needle biopsy.)

Once your pediatrician knows more about what is causing the hematuria, a decision can be made whether treatment is necessary. Often no treatment is required. Occasionally medication is used to suppress the inflammation that is the hallmarksign of nephritis.

Follow-up is important

Whatever the treatment, your child will need to return to the doctor regularly for repeat urine and blood tests and blood pressure checks. This is necessary to make sure that she isn’t developing chronic kidney disease, which can lead to kidney failure. Occasionally hematuria is caused by kidney stones, or, rarely, by an abnormality that will require surgery. If this is the case, your pediatrician will refer you to a pediatric urologist who can perform such procedures.

September 6, 2016


Febrile Seizures (Convulsions Caused by Fever)

Your child has reacted strongly to a fever by having a seizure. This information explains what to do if your child has a febrile seizure.

What are febrile seizures?

A child with seizures may have any of the following: stiffening of the limbs or the body, short, sudden jerking movements of the muscles that cannot be controlled and rolling back of the eyes into the head. A seizure almost always involves loss of consciousness, during which time the child is not responsive. When these seizures are caused by a fever, they are called febrile seizures. Most febrile seizures last for only a couple of minutes.

What to do if your child is having a febrile seizure

If your child is having a seizure, stay calm and take the following steps:

    -Keep your child away from sources of danger. Remove nearby objects that are sharp or hard.

    -Do not hold your child down or try to stop his movements. If you can, roll your child gently on his side or roll his head to the side so that any fluids can drain out of his mouth.

    -Try to put something soft like a folded jacket under your child's head. Remove any tight clothing, especially around your child's neck. Remove glasses so they do not break.

    -Do NOT try to put anything in your child's mouth. This could cause choking or broken teeth.

    -Your child's doctor will want to know how long the seizure lasts. If you can, look at a clock or your watch to see when the seizure starts and ends.

    -If the seizure lasts less than 3 minutes, take your child to the doctor or clinic right away. If the doctor's office is not open, take your child to a hospital emergency department.

    -If the seizure lasts more than 3 minutes, call an ambulance right away.

    -If your child has a seizure and does not have a fever, or if your child is unwell, then you need to see a doctor regardless of how long the seizure lasts.        

What to expect after the seizure

Sometimes children are confused or drowsy after a seizure and need to sleep for a while. Do not wait until your child has returned to normal to seek medical attention. Do not give your child any water, food, or medicine until the seizure is over and he is fully alert.

What to expect at the doctor's office or hospital

The doctor will ask you to describe the seizure carefully, including how long it lasted and how your child looked and moved. It may help the doctor to know if the shaking could be stopped with gentle holding of the shaking body part, or if the jerking movements persisted.

The doctor will examine your child. If the cause of the fever is known, and your child is not confused or unconscious, the doctor will not usually ask for any laboratory tests. However, if she suspects something else is wrong, she may order some tests. These will help to rule out any other possible causes of seizures.

If your child had a typical febrile seizure, he probably will not need to stay in the hospital. However, if your child has had an atypical febrile seizure (lasting for more than 15 minutes, more than one seizure in a 24 hour period, or if he is not back to himself and alert a few hours after the seizure) then the doctor may order tests and keep the child in the emergency room or in the hospital until the child is safe to return home.

Treating your child's fever

Fever may be caused by almost any childhood illness or infection. Often, febrile seizures happen just as your child's temperature starts to rise. You might not even know yet that your child has a fever. Treating your child's fever with medicine will not necessarily prevent a seizure or shorten the time it lasts, but it can help to make your child more comfortable.

Do not try to give fever medicine while your child is having a seizure. Wait until the seizure is over. Do not put your child in the bathtub.

Measuring your child's temperature

If your child feels warm, check his temperature with a thermometer. A normal temperature is 37.5°C (99.5°F) when taken by mouth, or 38°C (100.4°F) when taken rectally.


Give your child acetaminophen (Tylenol®, Tempra, Panadol®) or ibuprofen (Advil®, Motrin®, Brufen) for fever. Read the instructions on the medicine bottle carefully to find out how much medicine to give and how often to give it. If you are not sure, check with your doctor or pharmacist. Do not give your child ASA (acetylsalicylic acid or Aspirin) unless a doctor tells you to.


Keep your child lightly dressed. Remove heavy bedclothes.

Febrile seizures are common

Between 2-5% of children (meaning between two to five out of 100 children) will have at least one febrile seizure between the ages of six months and five years. There is a strong genetic component to febrile seizures. Parents of a child with febrile seizures often had febrile seizures too, and siblings are also more likely to have them.

Febrile seizures do not cause brain damage

A child's appearance during a febrile seizure can be quite frightening for parents. However, brief seizures do not damage the brain or cause permanent changes in the brain. Most febrile seizures last only a few minutes, although they probably seem to go on much longer. Even if your child has a long febrile seizure, the risk of brain damage is low.

Medicines to prevent febrile seizures

There are anti-seizure medicines (anticonvulsants or anti-epileptic drugs) that can prevent febrile seizures. These medicines do have side effects, and children who have febrile seizures do not usually need to take them. However, there might be special circumstances when your child's doctor thinks that an anti-seizure medicine is needed.

If your child often has febrile seizures, the doctor may give a short-acting anti-seizure medicine. The doctor will explain how to care for your child and when you need to seek medical attention.

You do not need to give your child special treatment

All children get sick sometimes, especially young children. Your child happens to react to fever in a drastic manner. Treat and protect your child the same way as any other normal, healthy child. Remember, fevers and seizures can start suddenly. If your child is under five years of age, make sure you stay close by when he is taking a bath. Do not leave your child alone in the bathtub.

Risk of another febrile seizure

Children who have a febrile seizure are at risk for having another febrile seizure. This occurs in about 30 to 35 percent of cases. A febrile seizure will not necessarily occur every time the child has a fever. Most recurrences happen within one year of the initial seizure and almost all occur within two years. A child is more likely to have recurrent febrile seizures if he is younger than 15 months when he has the first seizure and if he has a parent or sibling who has had febrile seizures or epilepsy.

Febrile seizures usually go away on their own when the child is older

Febrile seizures do not necessarily mean that your child will have epilepsy later in life. Fewer than five in 100 children who have febrile seizures develop epilepsy. Epilepsy is a condition marked by repeated seizures without fever.

September 4, 2016


There are both healthy and satisfying ways to handle the many food cravings that pregnancy may bring to expectant mothers. Food cravings during pregnancy are believed to be caused by hormonal changes that occur in the body. Generally, the first trimester is when the majority of cravings occur, but it is not uncommon for those cravings to last for the duration of the pregnancy. Finding ways to cope with overwhelming food cravings can be challenging for the mom-to-be, however, with some effort a healthy nutritional balance can be achieved.

Method One of Two:

Learning What Your Cravings Are Really For.

 Understand that some cravings are the body’s way of indicating a deficiency in nutrients.

For example, while a peanut butter and jelly sandwich on white bread may not be the healthiest sandwich choice, a craving for one may indicate a need for more protein in the diet, as peanut butter is high in protein. Try to recognize what nutrient your body may be lacking, before giving into your craving. Learn the important nutrients, such as protein, carbohydrates, iron, etc. so that you can isolate the healthy nutrients in the cravings you are experiencing.
        Cravings for cheesy foods and milk products could be the body’s way of indicating there is a need for more calcium.
        A sudden desire for a meal of chicken or beef may be an indication that the body is in need of more protein.
 Try to incorporate the nutrient into your diet in a healthier way.

For instance, instead of a peanut butter and jelly sandwich, make yourself a peanut butter, honey and banana smoothie.
        If you are craving something salty, try reaching for a few salted nuts rather than reaching for that bag of potato chips.
        Replacing your craving for a glazed fruit-filled pastry with some fresh fruit is a healthy option that still allows you to get the sugar you desire without consuming all those extra calories.
        Perhaps that craving for ice-cream can be satisfied with a lower calorie helping of yogurt.
        This technique may not always eliminate your cravings for unhealthy foods, but chances are that at least some of the time, it will. There’s also a good chance that you’ll fill up more on the healthy foods, and have less room for indulgences.
Remember everything in moderation.

If you have a craving for something like cheesecake (or another sweet, for instance) that cannot be replaced by a healthier alternative, it is okay to have it once in a while.
        A good rule of thumb is that having your treat of choice (for instance, that delicious piece of cheesecake) once a week is okay. What we are trying to avoid is having it in excess, such as every day.

Method Two of Two:

Don't let food cravings get in the way of a well-balanced diet.

During pregnancy, obtaining the proper nutrients in your diet is key, not just for your own health but for the health of the growing baby inside of you. While indulging your food cravings in moderation from time to time is okay, don't let it come at the expense of an overall healthy diet.

   -Healthy recommendations for pregnancy are (serving breakdown) a diet comprised of 20% protein, 30% fat, and 50% carbohydrates.

   -To break it down based on the food pyramid, an example of a healthy diet during pregnancy would look as follows: 6-11 servings of grains, 3-5 servings of vegetables, 2-4 servings of fruit, 3-4 servings of dairy, and 2-3 servings of meats, beans, or nuts.

    -Note that whole grains (and non-refined sources of carbohydrates) are a better choice, especially when it comes to keeping your blood sugars in a healthy range.
 Have healthy snacks available at all times.

This way, if you are having a craving, before you reach for a slice of cake or a piece of candy, you can see if you can satisfy your hunger with one of your pre-made healthier snacks.

Be aware of your weight gain and the impact food cravings may have on this.

   -In today's society, with rising rates of overweight and obese women, excessive weight gain during pregnancy can be a concern. If weight gain is a concern for you, avoid cravings for desserts and high-fat foods (such as processed foods) or high-calorie foods (such as excessive carbohydrates).
        On average, you need to consume only 300 more calories per day during pregnancy than you did prior to pregnancy.

  -Although you are "eating for two," the second is a very small baby so the calorie requirements during pregnancy are not much different than prior to pregnancy.
        The average woman should gain between 20 to 35lbs during pregnancy.

   - However, it depends on your weight prior to pregnancy, so speak to your doctor if you want specific recommendations for your own weight gain during pregnancy.
    Know which cravings are okay and which are dangerous. Although most cravings during pregnancy are okay in moderation, some women actually get cravings for non-food items such as dirt, clay, or laundry starch, among others.

   -This condition (of cravings for non-food items) is called "pica."
        While incompletely understood, it is hypothesized that pica may be due to low iron or other nutrient deficiencies (shortages of vitamins or minerals) in the body.

        -If you experience cravings for non-food items on any consistent basis, it is best to see your doctor for further advice.