Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
We offer many resources to help you and your partner prepare for your baby. Learn about what to expect during and after pregnancy including labor and delivery, breastfeeding, and when to call us.
Breast milk is the perfect food for your baby. There are many health benefits for you and your baby. According to the American Academy of Pediatrics, breast milk is the only food that your baby will need during the first 6 months of life. We recommend that you continue to breastfeed your baby for up to 1 year if you are able to. Even after you introduce solid foods, you can continue breastfeeding for as long as you wish.
Breastfeeding decreases your baby's risk for many types of infections and allergies. Benefits include:
Benefits to you may include:
There are rare medical conditions where breastfeeding is not advised. We can talk further if this applies to you.
Many mothers report that breastfeeding enhances a feeling of intimate contact between you and your baby. Babies relax and become calmer and mothers find that maternal feelings are stimulated during breastfeeding. You and your baby can get to know one another through your senses:
Breastfeeding works on a supply and demand basis: the more your baby nurses, the more milk you will produce. It may take some time for your body to get into a rhythm, so be patient and keep trying.
Your body knows exactly what to do to prepare you to breastfeed your baby. Your breasts have been changing during your pregnancy just for this reason.
Our breastfeeding basics class provides an introduction or refresher to breastfeeding, including valuable tips.
You can wear your regular bra while you are pregnant. However, if your breasts get bigger, a supportive cotton bra in a larger size may be more comfortable during pregnancy and while you are breastfeeding. This may also protect your breast tissue from stretching too much.
You can wait until the last few months of pregnancy to buy a nursing bra, when your breasts are at their largest. And you may still need a larger bra once your baby is born.
Some nipples look flat or actually pull back into the breast and look sunken or inverted after they're pinched. If your nipples are flat or inverted, talk to us about how you can breastfeed successfully. Many mothers are able to breastfeed successfully with flat or inverted nipples. Breastfeeding education and support are available.
To prevent sore nipples during your pregnancy, don't wash your breasts with a rough washcloth or pull on them. Rubbing the nipples too hard can make them sore even before you start breastfeeding. In rare cases, strong nipple stimulation causes some women to go into labor before the baby is ready to be born.
Even before your baby is born, the milk ducts in your breasts start collecting colostrum, which is a type of breast milk that appears late in pregnancy and during the first few days after birth.
Your breasts begin to produce milk about 12 to 48 hours after the birth of your baby. The new milk mixes with colostrum for a week to 10 days so that this transitional milk looks yellowish and watery. Mature milk is usually bluish white and looks somewhat like skim milk. Even though human milk looks watery, about half of the calories in breast milk come from fat.
As you begin to produce milk, your breasts will feel firm and full. Milk may start to leak from one side while the baby is nursing the other side. This mild engorgement is commonly referred to as "the milk coming in."
Milk production starts about 12 to 48 hours after your baby is born. Even before your milk production is fully ready, your newborn will begin to seek many hours of skin-to-skin contact, so your early attempts to breastfeed are beneficial.
You can use a breastfeeding log during the first week of feeding. Circle the time you begin each feeding. Check off a box for each wet diaper and a circle for each bowel movement.
You might feel that breastfeeding is unwieldy at first. There are 4 positions to try. See what works best for you and your baby:
As long as your baby is hungry, he or she will suck, pause, and swallow about once every second. When finished, your baby will stop sucking and may fall asleep. At times you may want to stop nursing when your baby is still attached to your breast. To break the suction, put your finger in the corner of your baby's mouth, between the gums.
Your breasts may become engorged (swollen) during the first few days of breastfeeding or when you cut back on nursing. Regular, frequent breastfeeding is the best way to prevent and relieve engorgement. What you can do:
Proper positioning will help you prevent soreness and cracking in your nipples. What you can do:
Occasionally, a nursing mother develops a blockage inside her breast that stops some of her milk from flowing to her baby. Sometimes this blockage (called a plugged duct) can cause the breast tissue to become infected. Signs and symptoms of plugged ducts include:
A milk duct can become plugged because your baby does not completely empty your breast during each feeding. This can cause milk to build up. This may happen if:
If you think you may have a plugged milk duct, it's important to take care of it right away so you can stop a breast infection from developing.
What you can do:
If left untreated, a plugged duct may become infected. This is known as "mastitis." The signs and symptoms of a breast infection may include:
If you have any of these symptoms, contact us right away. It's important that you immediately begin treatment with antibiotics. You should feel better within 24 hours with quick and proper treatment. Make sure that you completely finish all of the pills according to the schedule we recommended, even if you feel like you're completely well.
If your baby is healthy, it's not necessary to stop breastfeeding when you have a breast infection. The breast milk is not infected. Generally, breastfeeding helps your breast heal more quickly and continues to provide your baby all the usual benefits. But if your baby is premature or sick, check with your pediatrician to make sure it's safe to breastfeed while you have a breast infection.
What you can do:
Some nursing mothers experience milk leaking from their breasts between feedings. This can happen when your nipples rub against a bed sheet, bath towel, or clothing, or when you hear a baby cry. This is a normal sign of a strong flow of milk. It usually happens during the first few weeks of nursing as your body adjusts to producing just the right amount of milk for your baby. It can also occur when you stop breastfeeding or when you combine breastfeeding with feeding formula from a bottle.
Once you begin to recognize when your baby wants to eat, your breasts shouldn't leak as often. Going too long without nursing or pumping (more than three hours) can also cause leaking. If you are changing your nursing schedule from nursing on demand to nursing less often, you should expect a certain amount of leaking during this period. It will probably continue until your body has adjusted to the new schedule.
What you can do:
Increase your rest and nurse the baby frequently. Try staying in bed in your nightclothes and keep the baby with you to let him or her nurse on demand. Make sure that you are drinking enough fluids to satisfy your thirst. If this does not help within a few days, consider these options:
Please call our Appointment and Advice line right away if:
During your pregnancy, we recommend you enroll in one of our breastfeeding classes.
After your delivery, our postpartum nurses can help you with breastfeeding in the hospital. We also have lactation consultants who are specialists in breastfeeding who can answer your questions about breastfeeding and ensure everything is going well.
In addition to taking advantage of my online resources, I recommend you subscribe to our Healthy Babies newsletter. The newsletter is delivered to your e-mail in box each month, and has information and answers to common questions about newborn care and child development.
You can connect with me in a variety of ways, depending on the situation and what is most convenient for you at the time. I am available online, by telephone, or in person.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay current on your health status and to collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments as needed. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
My specialty colleagues are readily available to assist me if I need additional advice about your condition. In some cases, I may contact them during your visit, so we can discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.
As part of our commitment to prevention, additional members of our health care team may contact you to come in for a visit or test. We will contact you if you are overdue for cancer screenings or conditions which may require monitoring.
As your personal physician, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available 24/7 so that you can access and manage your care where and when it is most convenient. From my home page you can:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.