Sunday, October 19, 2014

It’s time to talk about the scary stuff.


No one likes to talk about dying, but accidents and illnesses don’t discriminate. Over and over I see families who had all the best intentions to get their estate plans in place, then they get caught off guard with a sudden death or diagnosis. No one thinks it will happen to them, until it does.

As a mother of two little girls, I more than understand that when you’re raising a family, your daily to do list becomes your top priority. Which in turn makes it hard to get everything else done. But this is an important one. Because, with estate planning, there is such a thing as being “too late.”

One reason parents procrastinate is their inability to agree on a specific guardian. Often times, this is so daunting that many parents give up before even starting. But as difficult as this may be, it is much better that you make this decision rather than a judge who does not know you, your children, or the potential guardians. Naming guardians yourself will avoid fights between both sides of the family and will protect your children from needless friction and heartache.

To learn more on how to name a guardian and protect your children with an estate plan, come to the next The Pump Station & Nurtury's Sizzling Hot Topic Lecture Invest in Your Nest: Protect Your Family with Estate Planning and Life Insurance on Nov. 5th in Hollywood and Nov. 11th in Santa Monica.  To register please call 310-998-1981 for the Santa Monica location or 323-469-5300 for the Hollywood location. Click here for class and instructor info.

If you have any questions about how to name guardians for your children, feel free to get in touch at 818-956-9200 or info@tatiyantslaw.com. I’d be happy to answer your questions. And remember, as overwhelming as it may seem, the alternative is much scarier.

Sona A. Tatiyants
Sona is the owner of Tatiyants Law, P.C., a law firm that specializes in estate planning for young families.

Friday, October 3, 2014

SoulCycle Pasadena Charity Ride!


Join The Pump Station & Nurtury, 
Pregnancy Awareness Month 
and Ergobaby on 
Monday, November 3rd at 9:30am 
at SoulCycle Pasadena 
for a charity ride benefitting Circle of Friends!


Monday, August 25, 2014

Rug Bug Music: In Tune With The Earth

We are happy to announce the start of our new Music Classes with Paulie Z!
Come try out this FREE Demo class
on September 22nd at our Santa Monica Store

Now taking sign-ups for the 8-week session starting September 29th. Parents receive a FREE Rug Bug Music CD when they sign up for the session.

For babies 0-12 months old

Class Description:
This environmentally-minded music program will accommodate even the youngest music-fan-in-training. Our classes include original compositions and all-time faves selected to inform and entertain everyone (you too, Moms, Dads, and caregivers!) With help from our signature Ballibrary (a carefully compiled assortment of spheres) and inspiring instruments recycled from common household objects, simultaneous to a swinging good time, students will be bolstering size, shape and tactile discrimination, gross motor skills, rhythm and reflex abilities and auditory development. There is little time to languish when youre a growing Rug Bug: dynamic ditties and compelling curios reinforce our eco-conscious outlook; without giving too much away, we suggest you come prepared to rock your socks off! And, while our musical medleys may alternate effortlessly between gentle and jamming, one things for sure: there is never a dull moment in a Rug Bug Music experience.

*For our youngest participants: With song sharing to accompany your day-to-day play, we'll equip you with music for every moment. Together with your family well provide the know-how to make your own great green toys, and suggest sweet, soothing ways to bond over books, blankets, baby sign language and massage. Last but not least, little hearts begin to learn how they can change the world by giving back.

Instructor Biography: 
As a professional musician and teacher, Paulie Z (Paul Zablidowsky) has a unique ability to entertain and educate simultaneously. Whether he's in a classroom or on the big stage, Paulie's number one goal is to keep you engaged and ensure that you have an unforgettable musical experience. For 16 years now, he has been teaching in private and public schools and has been touring and recording his own rock and children's music. Being a rock musician who works with children enables Paulie to connect not only to the kids, but to the adults and caregivers as well. To date he has designed and created original music programs and curriculum for kids ages 0-10 years old worldwide, released multiple rock and children's CDs, toured the country, starred in his own TV series, had a podcast on iTunes and even founded his own non-profit organization for kids!

Paulie's mission is to seamlessly combine his two passions in life: music and education.


Click here for more info or call 310-998-1981 to RSVP/Register.

Thursday, August 14, 2014

How Do I Know If My Child Is Ready for Potty Training?

By Jill Campbell, Psy.D.

There are many different reasons why parents’ feel the need to potty train their children.  Some parents feel pressure from their peers or family members, some fear that they are not doing a good job as a parent if they wait too long to potty train, others are pressured from their child’s daycare or preschool.  In addition, many parents are just tired of having to change diapers and eager to get on to this next stage in their child’s development.

For your child to be successfully toilet trained, however, he or she must be physically, cognitively and emotionally mature enough to understand and to control what is happening in the toilet teaching process.  If you begin to toilet training before your child is ready, chances are it will lead to a lot of frustration.  A child who is toilet trained much before the age of 2, usually has a parent who knows when to put the child down on the potty, and wait for the child to go.

Mark Wolraich, the author of the "American Academy of Pediatrics' Guide to Toilet Training," says that children typically begin to toilet-train between the ages of 18 months and 4 years. Some learn quickly and others take months. Many learn, and then regress. Accidents are common. Most children are daytime independent by age 4, but about  20% of 5-year-olds will still have some daytime accidents. Nighttime accidents can continue for much longer.  Wolraich says that the push for early training is more a reflection of parents' need for accomplishment than of any understanding of child physiology. "It's almost like a super-mom/dad issue," he said. "There's not been any evidence that children who get trained earlier are any smarter or more accomplished later in life.”
The AAP states that most child development experts believe that toilet training works best if it can be delayed until the child is ready to control much of the process herself.  Please remember that your child’s readiness for toilet training is not an sign of his or her intelligence, or your level of parenting ability! When your child is truly ready, physically, cognitively and emotionally, toilet training will happen much more easily.  It is important to go by your child’s cues for readiness.  The right time to begin this process will vary from child to child.
Signs of Readiness:
The more readiness signs that your child is demonstrating, the quicker and easier the toilet training process should be.  Look over the list below to help determine where your child is at in the readiness department.

Physical Signs:
Your child must have voluntary control of his or her sphincter muscles.  This means being able to open and close very specific internal muscles.  This gives your child the ability to delay excretion for a brief period of time. The AAP states that children’s sphincter muscles reach full maturity somewhere between 12-24 months with the average age being 18 months. While this is usually possible by about 18 months, this voluntary control only truly begins when a child can distinguish the sensations that precede a bowel movement or urination.  Due to this fact, most children will not be reliable until after the age of 2.

Your child is no longer excited about walking and being on his feet all the time.  He is at the maturity level where he is ready to sit down and learn a new task. Most children are at least 18 months, often older, before this happens.

Your child is more aware of his body and of the “need to go” (urinate or have a bowel movement) and shows it by facial expression, body gestures, telling you, and possibly going off somewhere (a corner of the room, behind furniture) when he/she feels the need to eliminate.
  • Your child is able to stay dry for at least two hours at a time during the day.
  • Your child often wakes up dry after a nap.
  • Your child urinates a lot at one time vs. a little throughout the day.
  • Your child usually does not have a bowel movement through the night.
  • Your child starts to urinate and move her bowels at more predictable times.
  • Your child does not like to be in dirty diapers and wants to be changed.

Cognitive and Verbal Signs:
Another sign that your child may be ready to be toilet trained is that he or she has good receptive language skills.  That means your child has the ability to understand what you are asking of him or her.

Your child can follow simple instructions.  For example, “Go to your closet and bring me back your red shirt.”

Your child can say the words “yes” and “no.”  She needs to have the ability to make her own decision about whether or not she is ready to use the potty.

Your child can express and understand one-word statements, including such words as “wet,” “dry,” “potty,” “pee,” “poop,” and “go.” Your child may even begin to tell you, “I peed.” Or “I pooped.”

Your child starts putting things where they belong. He may begin to pick up his toys. He may put his blocks in the box where they belong. He may start arranging and organizing things like his toys or his books.

Emotional and Social Awareness Signs:
Your child wants to please and imitate you. This natural ability to observe others and the desire to imitate them will help with the toilet teaching process.
  • Your child expresses interest in using the potty or toilet.
  • Your child wants to wear “big-kid” underwear.
  • Your child has a desire to master one’s own body and environment.  “I want to do it.”

Motor Skill Signs:
  • Your child can walk to and from the bathroom and help undress.
  • Your child is able to pull underpants and pants up and down.
--------------------
Dr. Jill Campbell teaches Toilet Teaching: A Gentle Guide to Potty Training Success at The Pump Station & Nurtury and partner locations.

Monday, August 11, 2014

Tax Day 2007, My Birth Story

by Cheryl Petran CEO, Owner The Pump Station & Nurtury™

I was due on April 15th, Tax day - but my little tax deduction decided to show up early. She was not about to make it easy on me – it was a taxing labor to say the least. I was grateful for what seemed like a pretty easy pregnancy.

I was due for a visit to my OB at 8 am Thursday April 12th. My contractions started around 4 that morning. I had a feeling I would not sleeping at home that night. I arrived at my Dr.’s and was 2 cm’s dilated. She was confident she’d be seeing me at the hospital by the end of they day. She decided to monitor my daughter’s heart beat, all was good – then, I rolled over so they could adjust something (don’t remember what). That’s when things started to get scary – my daughter’s heart rate started to crash. They repositioned me on my back and her heart rate got back to normal. My Dr. said I should go home, get my bags and meet her at the hospital in about an hour. Lucky for me my Dr.’s office, hospital and home were all within 6 blocks of each other. Finally, living in LA - I didn’t have to worry about hitting traffic.

I was checked into the hospital by 10am and contractions were getting worse but I was not getting any more dilated.  I had never written up a birth plan as I was told by many – it would only disappoint me as things never seem to go the way you want in labor. I decided to “manage expectations” – don’t have any and I won’t be disappointed. I think it was around noon when she decided to give me Pitocin to help things move along a little faster. Again, they rolled me over and my daughter’s heart rate crashed again.  They re-adjusted me again- her heart rate was fine.
This was about the same time I told my husband not to worry about me not eating – I told him to go ahead and have some lunch.  One of my more memorable labor moments – laughing while he ate the Izzy’s Reuben as I sat there rocking and fighting off the urge to take an epidural. I know myself, I probably was not going to make it without it but I was determined to go as long as I could. I’m a big ole baby when it comes to pain.

A few hours later my parents had shown up and I still had not dilated any more. The pain was getting worse but I was fighting it. I knew I wasn’t going to make it much longer. It was then that my new Hungarian Dr. Friend (HDF) showed up with a heavy accent and an explanation of what I might expect from taking the epidural. I remember his words before he left the room “when you’re ready – I’ll be right outside – ready to come in and give you the shot”. I was relieved and decided to try and hold on longer. It was now about 3pm I think when I just couldn’t take the pain any more I asked the nurse to send him in – remembering his words – “when you’re ready I’ll be right outside…..” Liar, Liar Pants on Fire!

It was 30 minutes before he re-entered the room. I should have sent out my cry for help about 45 minutes earlier.  He prepped me for the epidural and asked my family to leave the room. My husband was going to stay – but I told him he should go with my parents and get some coffee. They left the room, the Anesthesiologist returned and prepped me for my shot. I was told by many – don’t look at the size of the needle and you’ll be fine. I should have listened.

Not sure what happened next but – I got the epidural, her heart rate crashed again and I was quickly inverted head and upper body positioned back, lower body up and I seem to remember some type of face mask.  Doors were closed and my husband came rushing in, not knowing what exactly had happened. My Dr arrived within a few minutes (she too lived a few blocks away) and said that’s it – we need to do a C-section. We were told that she was concerned about her working to get thru the birth canal – she could barely handle me rolling over so let’s not take any chances.

I was then prepped for surgery – more drugs. By the time I was brought in I was starting to feel sicker and sicker. My HDF was behind me over my head monitoring my meds. He was telling me to relax all would be ok. I was feeling sicker and humiliated at the thought that all of my privates were currently exposed to the world.  I’m generally very modest, still haven’t subscribed to the “Selfie” craze.  I began to vomit – my HDF started giving me ice chips. I kept thinking about being naked to the world (my world) at that time. I was still vomiting. Not one of my prettier moments.

The next thing I knew my husband was showing me a photo of my little girl. In the phone she just looked so big – I remember thinking, “wow, that big baby came out of me?”  I was still vomiting and now shaking non-stop. I was in no condition to hold my baby. Daniela Mary Petran was born at 7:12 that evening.  She was 19” long and weighed 6 lbs and 5 oz. She was not big – so basically the camera begins to add weight at birth? That’s just not fair.  

The next thing I remember is waking up in the recovery room around 11pm. I finally got to hold my baby but I was shaking incessantly. I gave her back to my husband (or was it the nurse??) I was terrified I’d drop her. I’m pretty sure they put her to breast but can’t remember as everything was so foggy.

It was a long and scary day. Taxing. For the longest time I thought of how I missed that precious opportunity to hold my baby skin-to-skin at birth. I had an insanely difficult experience breastfeeding – developed a horrible case of mastitis.  I felt I failed at so many things early on as a new mom. I wondered if I had damaged my little girl in those early moments of her life.

7 years later, I’m pretty sure that didn’t happen. On Sunday morning I landed in Boston with my little “tenacious D” (that’s what we call her). She was there holding her baby – tightly swaddled and staring into her eyes. She’s a good Mommy, she practices skin-to-skin, swaddling, soothing techniques (thank you Dr. Karp) and breastfeeding her doll. Yes, she breastfeeds her doll. She is a caring and nurturing mommy. I did something right.


I’m hopeful that some day when she has babies of her own she has a more pleasant birth experience. But if she doesn’t well that’s ok too…. Payback…..

Sunday, July 13, 2014

Breastfeeding and Contraception – The Progesterone Controversy

Sara Twogood, MD

As an OBGYN, I was well aware of the intense post partum changes that I should expect from my own body.  The biggest challenge of all, and one that my medical experience didn’t prepare me for, was the sometimes painful, emotionally turbulent, and occasionally wonderful experience of breastfeeding. Happily, I was going to the breastfeeding support groups at The Pump Station & Nurtury™. They provided me with a wonderful blend of camaraderie and information. Much of that information was new to me, but I soon came to realize that there was at least one area about which my group-mates often had questions in which I was well versed. At almost every class, someone would ask about contraception choices – what was the best to use while breastfeeding? What was safe? Knowing I was an OBGYN, our group leader would defer these questions to me. There are certainly many possible choices, but the most controversial seems to be the questions surrounding progesterone. The lactation consultant would inextricably tell women that it would decrease milk supply, citing expert opinion and legitimate sources. The medical literature I was familiar with told me that progesterone would have no effect at all on breast feeding.

So which one was it? Are progesterone methods of contraception friend or foe to the breastfeeding woman?

I did a thorough medical search and found a ton of information (some helpful, some useless). I am clearly not the only person trying to answer this question.

Before I go through this information, let me get you up to speed with progesterone contraception.

Progesterone forms of contraception:
·      The progesterone only pill: AKA “mini pill”. It is a miniature version of the combined oral contraceptive pill (our beloved “the pill”). It’s miniature because it only contains one hormone – progesterone. The combined oral contraceptive contains a combination of estrogen and progesterone. Everyone agrees that the estrogen component decreases breast milk supply, so we aren’t talking about this pill now.  The other difference is that the progesterone only pill does not have a placebo week – you take a hormone pill every day, and your period comes when it wants to (ie irregular bleeding is common … as it is with all of these forms with progesterone only). 
·      Depo provera injection: an injection you get every 3 months. It gets a bad rep because it’s been linked to weight gain (not sure if it’s causal or an association only) and depression (in a small percentage of patients only). Some patients love it. Some hate it.
·      Nexplanon: the implant. Former incarnations are Norplant and Implanon. It’s a small rod placed under the skin of your arm and secretes a small amount of hormone daily over the course of 3 years. It’s one of the most effective forms of birth control on the market today.
·      The Mirena IUD also contains progesterone. You probably recognize the name of this IUD from commercials, although I can’t guarantee your life will be like the ads - all flowers and sunshine - with its use.

Progesterone types:
There are many different types of progesterone used for contraception – names like norethindrone, levonorgestrel, norgestimate. They vary slightly depending on the delivery method (swallowed, injected, etc), but are sometimes lumped together for ease of analysis.

What do the studies show?
I don’t want to bore you with the extraneous details (I bored myself reviewing some of this information) … but here’s the gist:

Lactation is made possible, in part, because of a sudden drop in maternal progesterone levels the first few days post partum. Addition of a progesterone at this time may, theoretically, halt this natural process.


Current evidence to support either argument is weak. The studies are not uniform. The outcomes are not consistent.

·      A large international study conducted by the WHO tells us that the use of progesterone contraception, in various forms (including the pill, the injectable, and the implant), will not affect breast feeding performance or rate of infant growth.
·      A small cohort of women reported a significant decrease in milk production after taking the progesterone only pill. When most of these women stopped taking the pill, their milk supply returned.
·      In a different study with the progesterone only pill, there was no change in milk volume in the first months after initiation. At 18 weeks of use, there was a 12% drop (compared to a 6% drop for women not using hormonal contraception). However, supplemental feeding was the same in both groups.
·      In a study of urban women, when Depo Provera (the 3 month injectable) was given immediately after delivery, there were no detrimental effects on duration of lactation, frequency of lactation, or timing of introduction of formula within the first 16 weeks post-partum.

Still confused?
I don’t blame you. I haven’t given you an answer because there is no straightforward answer.

My Counseling:
I believe that large studies show us, overall, that progesterone only contraceptives CAN be a good option. They are unlikely to have a detrimental effect on breast feeding or infant outcomes. This is the information your OBGYN will site. I know I have. BUT, and I urge to remember this, some women may be sensitive to progesterone. Lactation consultants see this sensitivity consistently and with more frequency than the literature suggests. Although the data is unpublished and at this point anecdotal, I believe it is enough to question progesterone only methods. Breast feeding is hard enough as it is ... your choice of contraception should not make it harder.

I suggest you proceed with caution:
·      Non hormonal methods of contraception will avoid any risk to your milk supply.
·      If you do decide a progesterone form of contraception is right for you, follow these guidelines:
o   Wait about 6 weeks after delivery before starting, so your milk supply is established.
o   Use a rapidly reversible form, like the pill. You can stop and reverse the effects (hopefully) if you do notice a drop in supply. With the option of Depo Provera, if you notice a drop in your supply, you can’t reverse the effects any faster than the 3 months it will persist. The implant and IUD are quickly reversible, but it would be a shame (both physically and cost effectiveness) to remove these shortly after insertion.

Get educated on all forms of contraception. Come to my class, Sex and Contraception for the Post Partum Woman July 18th at 1pm at The Pump Station-Hollywood to learn more!

I write about additional reproductive and fertility issues on Dr. Sara Twogood’s LadyParts Blog. Visit me at LadyPartsBlog.com