If I could just do one thing for myself it would be to appreciate and be grateful for what I have every single second of every single day. To me personally, I think this is the key to happiness in life. Whatever your situation might be, there has got to be something to be grateful for, even if it’s just a smile or a nice cold glass of clean water to drink.

Easier said than done because I have been aiming for this goal for quite some time and really don’t expect myself to accomplish this goal any time soon no matter how hard I try. Though I know this might sound like a negative comment, I say this out of truth because life is full of obstacles and battles that can constantly beat us down and make us forget the clarity of what we want to be the truth most days. As humans, we all have our personal demons we have to fight. Mix that in with the everyday issues imposed by the outside world and it is no wonder most of us live like robots and succumb to the comfort of ‘just being’.

This topic is especially important to me because during my first pregnancy, I had the typical fears of my baby not being born healthy as any new mom usually does. I had no reason to think this at all as all my tests and health was perfect, it was just a natural feeling most of us get of the unknown. Human nature I suppose. Well, during this time, I prayed to God and told him that if my baby is born healthy, I will not ask for anything else in life and will be grateful and happy forever. At the time of asking, I truly believe this, and it gave me so much comfort. Well, God answered my prayers, and my daughter is a healthy, vibrant, smart, sweet, beautiful (every good word you can think of) little angel. Yes, I got the daughter I wanted and yet soon after birth, I saw myself get consumed with emotions that took me away from the promise I made. (Yes, I feel guilty about that and like to remind myself of this promise when I am the most angry/annoyed/pessimistic because it brings me back to clarity).

It’s the lack of sleep, the pressures from other people, the expectations, it’s trying to do too much, it’s the financial worries, the change of pace, the computer breaking down, it’s the everything that happens from regular everyday life that consume us and make us forget how blessed we truly are.

Everything is relative I know, there are those that seem worse off and those that seem better off, but if we are to look into our lives and do it in a way where we are not comparing ourselves to others and in way that we are just accepting of what is going on around us and truly learning to appreciate what we have we would all ultimately be happier. Also make note that I said other’s ’seem’ to be worse or better off. This is just a judgement on most of our parts because we never know exactly how it is unless we are in their shoes. You can never judge a book by it’s cover or in this case, but how much we percieve them to have or don’t have.

The thing and situation we are at now is how do we get to this state of gratefulness. Is this what most religions try to teach us? Is this Nirvana? Is this peace? I have no idea. All I know is that it definately takes a lot of practice and more than a few constant reminders daily to get me to a level where I can even start to be truly grateful. Here are a few things that keep me positive when life turns ugly.

1) Know “It could be worse / Things happen for a reason”. You are late for a meeting and your car breaks down in the middle of nowhere. Yeah this could really suck and ruin your day but what if it was meant to happen because if you could see the bigger picture and continued on your trip, you were in this horrific accident where you could never see your family again. Instead of being angry, you would feel rejoiced and thankful for your car breaking down.

2) Thing Big Big Big Picture. Visualize yourself in a room, now zoom up to the house level, now your block, then your city, then your state/province, then the world… see how small your problems are getting? Keep going… Now you are in space, the galaxy, the universe and beyond. You can’t even see your problems anymore because in the grand scheme of things, these problems like others will pass and fretting just became a trivial small matter.

3) Write reminders and notes in places arounds the house to remind yourself. I got this from my brother as he wrote on his mirror, ‘Be Grateful’ or a sticky note on his laptop ‘Sit Straight’. Though these sound like small things, these are just small gestures to remind yourself that you want to be better daily.

4) Keep a ‘gratefulness journal’. Everytime you feel blessed and happy, write it down! Most of us write as an outlet when we are upset or bothered in some way. Reverse that and write when we are happy to remind yourself that life IS GOOD. Be detailed with your feelings so it can take you back to that state. And as a bonus, when you are feeling sad, go back to this journal and read it.

5) Try to surround yourself with positive. Hang out with people that make you happy. We all know the only person that can change themselves is themselves alone so don’t try to change or accept being around a negative person because it WILL wear off on you. I say try to do this because some of the people in our life we can’t get rid ofnstead we should try to accept, support and just be better ourselves for them. For people you can get rid of or people you just don’t need in your life, shake them off. You off for it.

6) Give Back. Yes this works and it makes you feel so good. Everytime I have a bad day I go to Kiva.org (an organization that does microlending for small business), I go and choose someone in the world to help. This is a great way for me to feel good about doing something greater in the world because you are lending the money not giving it away to someone who might just be accepting charity. I have issues with people who cannot help themselves and not doing anything with their lives. Giving to charities that I feel just ‘waste’ money or distribute money where I have no idea where it goes, doesn’t make me feel good. Choose a charity that fits your style of thinking and stick with that. (Note to self: I should give more to Children’s Hospital).

I hope this entry gives everyone that needs a bit of clarity some insight on what to do and how to move forward towards happiness. If there was one thing human beings need to work on, I personally believe it is this.

What might work for me, might not work for you, so learn to create and add your own items to your “gratefulness” system. I guarantee that if you can achieve these goals and come to a good concious level of this, life will be much happier for you and everyone around. I wish you and I lots of luck!

The other day, I went into my trusty calendar to plot out all the lessons, special events, etc. from now until December.  I’m sure all you other parents out there have done the same and found your calendar incredibly full already.  How can little beings in our world take up so much of our time?  But they do because we also want them to be introduced to as many experiences as possible. 

But do we ever schedule down time?  I know that our family has and it has helped us tremendously in decreasing our stress levels.  For example, my kids actually go to 6 days of school (5 days of regular school and ½ day on Saturdays for Chinese school).  That would be a lot for me let alone a little person.   After Chinese school, there is nothing but fun.  We tend to stay home on Saturdays so that the kids can roam the house, find activities that they want to do, or just hang out with mom and dad doing a quiet activity.  I find that one kid tends to go to her room, sit and read, then play with her stuffed animals.  The second kid wanders to her computer, plays in her big cardboard box and maybe watches some tv.  If it’s nice, we’ll go out and blow bubbles, ride our bikes or just walk down to the local store to get a slurpee.  Sometimes, we just watch a silly movie with popcorn and treats about.   

I know it may seem silly to plan down time.  But if you don’t plan it, some other event, duty, chore will have to take that time slot.  Everybody needs down time, especially the little ones.  Though these down periods are not rocket science lessons, we are teaching them a life lesson that taking time for themselves is ok and extremely healthy.   And in the short term, everybody seems to be much happier and ready to take on the next day. 

So don’t be shy and plan down time.  It’s good for the whole family.

One of my least favourite activities these days is changing my toddler’s diapers. I look back on the gooey, runny poohies of my once-an-infact with nostalgic fondness. There’s nothing I hate more than a poopie toddler squirming her way to get out of being horizontal, while digging her toes straight into the goo.

For the benefit of my nerves, I’ve tested out many an activity (aka distraction) to get my toddler to lie still, some to my amazement have actually worked. My top 3 winners are:

FAMILY BOARD : Create a place where your little one can look at (and most importantly, play with) pictures of people in her family. Take a bulletin board (best to use the ones with ribbons so you don’t have to deal with the dangers of pushpins) and place it just above where you change your toddler. Cut out photos of each of her family members and attach a sticker with their name & title (i.e. Aunt, Cousin) on it. When you go to change a diaper, have her select which member(s) she would like to hold/play with today (be patient, my toddler usually takes 5 mins to find the one she wants) while you get the job done. Not only does this help her associate names/words with her family, but in a day when everyone seems to have most of their relatives in different states or countries, it helps to remind them that they are loved by many, even people far away. If the lying down position is still a struggle, have her stand while you attend to the task and select the relatives herself.

HAT RACK: Install a small hatrack or shelf just above where you change diapers. When you lie your child down for a changing, put on a hat and make a silly face. Change up the hats and play peek-a-boo with them. Try adding glasses, maybe a scarf… Have her take them off you and play with them. I pretend to be characters each with a different voice that each hat represents. Go crazy with it until you elicit a giggle!

LET THE WIND BLOW: Place a small table fan in arms reach of where you change your toddler (preferably on a shelf just above them). Just after you lie them down, turn on the fan, letting it blow a gentle wind on their face. This will usually startle them enough to put a stop to the tantrum for a moment, so you can then hand them a toy, sing them a song or play “Where’s my nose?”. Turn the fan off when you are undressing them, so as to not let them get cold. After clothes are back on, I usually turn it on once more as she’s waiting to see it again and feel the wind.

Good luck!

Ok, there are so many online articles and blogs about gender prediction that I actually told myself I wouldn’t blog about this subject a few years ago. I don’t listen to myself obviously because here I am blogging about it. But I have good reason ok?! If you have read my previous blog entry about the Ultrasound mix-up when I tried to find out the gender of this baby in my tummy you will know why I’m as obsessed as I am. I have been all-consumed with worry & doubt. Is it a boy? or Is it a girl? I’m sure all you mom’s out there hoping for a certain gender feel the same ways as me. Why this is important I don’t know, but it just is to me ok? If you are like me, you like to know and be confident knowing right?

Well, today I did some gender predictor tests online (the old wives tale kind) and all my results are falling around the 47% boy, 52% girl mark… not a very strong prediction I must admit.

And Here’s Why…
You are carrying the extra weight out front, so it’s a boy.
The hair on your legs is not growing any faster during your preganacy, so it’s a girl.
Girls are carried high. You are going to have a girl.
Sleeping in a bed with your pillow to the south indicates that you will be having a girl.
Your feet are colder than they were before pregnancy. You are having a boy.
You prefer the heel of a loaf of bread. You are having a boy.
Dad-to-be hasn’t been gaining weight along with Mom-to-be, so it will be a girl.
The maternal grandmother doesn’t have gray hair (dyed or natural), so a girl will be born.
You didn’t have morning sickness early in pregnancy, so it will be a boy.
You are not looking particularly good during pregnancy. Therefore, it must be a girl, because girls steal their mother’s looks.
Your chest development has not been very dramatic during pregnancy. You should expect a boy.
Since the sum of the mother’s age at conception and the number of the month of conception is even, it will be a boy.
A needle on a thread held over your belly moves in circles, so you will have a boy.
Your urine is a dull yellow color, so you will have a girl.
You have a craving for salty or sour foods, which means that it is a boy.
Your nose hasn’t changed during pregnancy, which indicates a girl.
You have been craving fruits, so it is a girl.
Your baby’s heart rate is 140 or more beats per minute, so it’s a girl.
You have no desire for orange juice, so it’s a boy.
You are having headaches, so it’s a boy.
Your belly looks like a basketball, so it’s a boy.
You show them the palm of your hand, so it’s a girl.
You use the body of the mug, so it’s a girl.

Go ahead if you want take the test yourself here: http://www.childbirth.org/articles/boyorgirl.html. Sort of dumb if you ask me.

Finally though, I have found one that is accurate to my LIKING and fitting to my past pregnancy (a true indicator as I already know she is a girl). Being Chinese and all, I thought maybe it just had to do with my background. Who knows, but I am leaving comments open on this blog so you can let me know if this chart works or doesn’t work for you. Either way, it’s entertaining and I liked the results so I’m sticking by it.

Note: I have tried other Chinese gender predictors before and it was all wrong! Maybe because its the exact reverse of this one!

It predicted my first pregnancy correctly which is a girl & also with my second, which it says it’s going to be a boy (as Doctors have told me).

See for yourself and let me know if it works for you:

Chinese Gender Prediction Chart

Notes about this Chinese Gender Prediction Chart: According to legend, the Chinese birth gender chart is based on statistics taken from women inside the Forbidden City during the Ching Dynasty. Around 700 years ago, a Chinese scientist discovered the birth gender chart buried in a royal tomb. The original gender chart is now kept in the Institute of Science of Peking. Supposedly, it’s 99 percent accurate!

Entertainment purposes only. Just cause it worked for me, doesn’t mean it will work for you.

All parents strive to provide their kids the best of everything.   We try to give them all the possible lessons, possible activities, possible toys, and the list goes on.  But all of these ”things” require money.

So, when parents go searching for a job or they stay in a job that they hate, they’re thinking of the bottom line.  I’m taking home X number of dollars which will support my family and all the things that we want to do.   And if it’s not enough and if an opportunity comes up, they may go to a different job because it pays more.

But what people don’t realize is that they should also look at the benefits.  Yes, the medical, dental and vision types of benefits are tremendously helpful.  But I’m talking more about the benefits that help you achieve work life balance.  As a mother of 2 who works full time, I absolutely believe in work life balance….it’s what helps me stay healthy to ensure that I can take care of my family.   And by looking at my company’s benefits, that’s why I opted to stay in a job that doesn’t pay as well compared to the same job at another company.

For example, my boss allows me to bring  in one of my kids that attends a daycare nearby from 7am to 7:30am as my start time is 7, but the daycare down the street does not open until 7:30.  This one small gesture allows me to start early rather than an hour later which also means I get off work early too.  It also allows me some extra time with my one kid in the morning and she gets to see what I do.   By working a 7am to 3pm schedule, I can pick up the one kid at daycare and then zip to my other kid’s school to pick her up.  I’m home by 4:30pm to help my  kids with any homework they may have, cook dinner and be finished dishes by 6:30pm.  That leaves me a whole evening to be with family or catch the news or whatever the heck I want.

My company gives me 5 family days a year.  That’s 5 days that I can take off for my kid’s appointments, or stay at home with her because she’s sick,  to go to her school play, or anything related to my kid.  Yes, 5 family days on top of my holidays and sick days.

These are small examples of policies and practices that make it easier to work and have a family.  I get that not all companies will have such family friendly policies and that they may be hard to come by.   I also get that sometimes it really is about how much you bring home (hey, I’ve had really tough times financially before so I get it).  But if you do have a chance where money isn’t so much an issue and it’s more about making a good choice for yourself, really take a look into the family friendly policies at your potential new job.  Your sanity and your family will thank you.

1) Get everyone involved in saving money when eating out
The next time you go out to eat with your family give everyone a maximum amount they are allowed to spend on their meal. This promotes good financial practice for all members of the family and you can even turn it into a game to see who can save the most.

2) Leave special notes in your kids lunch box or notebook
Put a little note in your child’s notebook or lunch box once in while so that when they get to school they have that little extra love from you. Guaranteed to brighten their day. This is great for the beginning years especially when they want to be home with their mommmy.

3) Start a Gratitude Box Tradition
Have a craft session with your kids. Take an old shoe box and cover it with paper & have everyone get involved and decorate it. Cut a hole in the top for inserting paper and every week have your kids write something they are grateful for in their lives. This makes us all step back and be more grateful for our blessed lives. You can even save them all year and opening them during Thanksgiving.

4) Share Babysitting with Friends
What’s more reliable than having another mom that knows your kids take care of them. Find friends and family that have kids and offer to schedule some time for swapping some babysitting times so that the adults can get out and do their own things, while the kids have some play time with their friends. Plus an added bonus, it’s free.

5) Wake up to Music in the mornings
What better way to wake your kids up in the morning than to put on some good ol’music. When kids wake up themselves, they tend to be less cranky and more willing to get going. Plus this starts a fun family tradition the kids will remember for their life time.

6) Sneak Vegetables into your Home-Cooked Meals
Sounds bad I know, but we moms do what we can go get our kids & our partners to eat healthy. This is especially easy to do when making sauces for spaghetti or creamy casseroles or even meatloaf. You can puree mashed eggplant, cabbage, carrots etc. and it adds some much flavor to the food.

7) Dilute Juice to Reduce Sugar Content
Before I serve real fruit juice to my family, I always pour some out and add 1/6 portion of water. This makes me feel better about them drinking the juice as my family members are huge juice drinkers and you know they won’t just drink just 1 cup. Make sure they don’t see, especially the hubby because he will start suspecting it.

Chore & Prize Lottery
You will need two “fish bowl” like containers. Fill one fish bowl or container with chores and the other with prizes. Every week, have your kids pick out a chore that they need to do and when they are done, they get to choose one out of the Prize bowl. Prizes can include things like pizza night coupon, choice of movie on movie night, any snack of choice at any time, double allowance etc.

9) Pack Outing/Snack Fun Bags
Whether you are going to a movie, the park, the aquarium or even a restaurant, never leave home without packing an Outing/Snack Fun bag for each child. You never know when they need something familiar or maybe even during the car ride. Include such things as favorite cookies, treats, card games, crayons, small note pads, stickers and juice boxes.

10) Make Milestones Extra Special
Some things only happen once so why not go the extra mile to create those extra memories that will last forever. For example: Make loosing a tooth a real special event. Put a fairy dust trail from the window to the bed where the tooth went missing. Kids notice all the small stuff. They will talk about it for weeks!

I am awake at 4:18AM blogging about insomnia because well, I am 23 weeks pregnant and just got hit recently with an unwanted bout of “pregnancy insomnia”. Man, this really does suck, but it happens, and it happens to almost 80% of us sometime during our pregnancy (as statistics say anyhow!). Well at least I am not alone right? Well to be honest, that doesn’t make me feel any better that there are woman out there suffering like I am. Why does this happen and what can I do to get back to bed?

Pregnancy insomnia is like non-pregnant insomnia as it could be caused by things like you can’t get comfy, you don’t feel good, you have too many thoughts in your head, you feel anxious, you have cramps, you have to pee constantly, you have heart burn or maybe a combination of these or maybe even all of them. So what to do? what to do?

Here are a few ideas:

1) First off, if you have been lying there for more than 1 hour, just get up! Figure out what is on your mind, whether it is work, baby, relationship whatever and go write it down on a piece of paper and just get it out.

2) Don’t drink any more water and if you have to go pee, go pee. Don’t turn the lights up too high if you can because you want to keep your surroundings as dark as possible so your body still knows it’s night.

3) Do something that makes you tired. For some it’s a massage, reading a magazine or a book, having sex, or listening to soft classic music. Whatever you do, don’t do something that is stimulating to you. E.G., For me watching TV makes me wake up.

4) Try to clear your mind and think about sleepy thoughts. Yes, if you have to, try to count sheep. It’s hard to just shut your mind off, but a great sleeper once told me a trick. Stare at a single spot with your eyes closed and keep your mind blank. It hasn’t worked for me yet, but he falls asleep within 2 minutes so, it might work for you.

5) Don’t stress about not sleeping or having to wake up in a few hours. Enjoy the quiet moments of the night and the darkness.

6) Get as comfy as you can. The body pillows really do help during pregnancy. Hug it tight and make sure you are at a good temperature. The warmer you are, usually, the sleepier you will get.

7) If this insomnia is ongoing for more than a few days, try to watch what you are doing during the day and don’t do things like take late naps, drink too much caffine, eat sugar late in the day, or eat food that will irriate your stomach such as spicy foods.

If none of these things help, seeks some professional medical help because sleep is so important. I feel my eyes getting tired so I should listen to my body cues and not resist. You should too try some of these techniques and I hope you get your zzzz’s.

Fall is here again! The leaves are turning those beautiful yellow, reds and oranges, the days are getting chiller and it’s time again for comfort foods! This is definitely one of my favorite times of the year and I love everything from the season’s colors to wearing warm sweaters.

It is also back to school time and that means lots of fun treats for the kids. I am a lover of rice krispy squares (not only are they yummy and a classic, they are easy to make!)

Here is an “autumny” spin of Rice Krispy treats straight from the elves themselves:

Chocolate Pumpkin Eaters

Directions:
1. In large saucepan melt butter over low heat. Add marshmallows and stir until completely melted. Remove from heat.

2. Add KELLOGG’S RICE KRISPIES cereal. Stir until well coated.

3. Using 1/2-cup measuring cup coated with cooking spray divide warm cereal mixture into portions. Using buttered hands shape each portion into ball. Push one pretzel piece into each. Cool.

4. In small saucepan combine chocolate morsels and shortening. Cook over low heat until melted, stirring constantly. Dip tops of balls into chocolate. Decorate with sprinkles. Place on wax-paper-lined baking sheet. Refrigerate until chocolate is firm. Individually wrap in plastic wrap. Best if served the same day.

MICROWAVE DIRECTIONS:
In microwave-safe bowl heat butter and marshmallows on HIGH for 3 minutes, stirring after 2 minutes. Stir until smooth. Follow steps 2 and 3 above. In small microwave-safe bowl combine chocolate morsels and shortening. Microwave on HIGH for 1 minute or until melted, stirring every 15 seconds. Continue with recipe as directed above. Microwave cooking times may vary.

Note:
For best results, use fresh marshmallows.  1 jar (7 oz.) marshmallow crème can be substituted for marshmallows.  Diet, reduced calorie or tub margarine is not recommended. Use Real butter if you can!  Store no more than two days at room temperature in airtight container. To freeze, place in single layer on wax paper in airtight container. Freeze for up to 6 weeks. Let stand at room temperature for 15 minutes before serving.

For more similar recipes like this visit: http://www.ricekrispies.com

There are so many resources for the newly pregnant, especially on the internet, that it can be overwhelming at times. Sometimes messages can be helpful, sometimes conflicting, sometimes just plain useless and when you are new at this pregnancy thing, where do you start? Well, after surfing the web for the last few years throughout my last few pregnancies I found this Early Pregnancy Checklist a great place to get started. Those these things might seem like common sense, I find it’s helpful just to have a guide for a bit of clarity (the baby steals brain cells, don’t u know?

Your Early Pregnancy Checklist

Your health

• Avoid alcohol, drugs and cigarettes
• Consult with your doctor before taking any medication
• Get plenty of sleep – and try to nap when you’re tired
• Exercise moderately, but avoid starting a new exercise regimen
• Be careful not to become overheated for prolonged periods of exercise
• Many women experience nausea in their first trimester – try eating dry crackers or smaller meals throughout the day

Your nutrition

• Boost your energy with high-protein and healthy carbohydrate foods  like brown rice, hard cheeses or multi-grain breads. You can find  more information from Canada’s Food Guide to Healthy Eating at www.hc-sc.gc.ca.
• Eat foods naturally high in folic acid like oranges, melons and  dark-green, leafy vegetables
• Drink lots of fluids – especially water (8-10 glasses a day if you can)
• Eat plenty of iron-rich foods like whole grains, beans, raisins and nuts
• If you love coffee – try to cut back, or try decaffeinated coffee  or tea. Visit Health Canada’s website to find out which teas are  recommended and how much caffeine is okay
• This is no time to diet. Eat well and make healthy choices.

Your healthcare

• Schedule your first prenatal visit with your doctor as soon as you think you’re pregnant
• Plan to visit your doctor every four weeks throughout your pregnancy, increasing visits as your pregnancy progresses
• Inform your doctor if your immunizations are not up to date
• If your family has a history of genetic disorders – talk to your doctor about prenatal testing
• Choose a place to give birth (hospital? home? birth centre?)
• Choose a healthcare professional (GP, Ob-Gyn, midwife, doula, or combination)
• Consider taking a prenatal vitamin supplement every day

Your lifestyle

• It’s never too early to start budgeting for your new life with baby (e.g. what is the cost associated with storing your baby’s cord blood?)
• Consider starting a pregnancy diary or a photo diary of your changing body
• Avoid perms, colour, highlights or hair treatments that use heavy chemicals – especially during your first trimester when the fetus’s organs are developing and most susceptible to damage from toxins, drugs and infections
• Visit a bookstore, friend’s house or a library and buy or borrow a few pregnancy books (baby learning is always fun)

Who said pregnancy was a piece of cake? Not only am I growing bigger every day, now my skin has to itch too?? I have heard of so many mother’s complain about itchy skin from stretching, heat, etc., during pregnancy  but I had no idea it would be this bad. I guess during my first pregnancy I had it really good as I didn’t have this problem what-so-ever. This time around however, I find myself scratching all the time and it is driving me crazy! I have spread it to 3 areas of my body and have been self medicating it with hydrocortisone creams until I am able to see my doctor again for some better advice. I truly believe I have got some form of eczema, a symtom I have never had before in my life until now. Being pregnant during the summer months and the excess sweating also does not help the matter any as well. I have been doing light showers throughout the day, using baby powder afterwards and other times (such as bedtime) the over-the-counter hydrocortisone cream. Also I try very hard not to scratch because I am worried that I will break the skin and spread the eczema making the problem worse. Easier said than done of course because sometimes I find myself waking up in the middle of the night scratching. The things we woman have to go through during pregnancy can really suck. Hopefully the body goes back to normal after pregnancy and our skin won’t continue to act so strange. I have heard instances where the mother can pass the infection to the newborn during contact while breastfeeding, so make sure you talk to your doctor about any skin problems you may have and know exactly what you have and how to treat it properly.

Most resources online note that skin disorders or changes in the texture of skin are the most common changes experienced by every female during pregnancy.

“During pregnancy a woman’s body experiences many changes including hormonal changes, certain changes in your skin and also blood pressure changes.

Eczema is a skin inflammation which is mainly caused when your skin comes in contact with certain types of allergens to which your skin is sensitive and can lead to several allergic reactions.

These allergens could be soaps, creams, jewelry, clothing, bacteria and it can also be caused due to excess emotional or mental stress.

The changes in the body functions during pregnancy can vary from one woman to other. If you have eczema before pregnancy, then the risk of this skin inflammation to become worse can be high for you; while for the other woman suffering with the same skin disorder, can be at lower risks of this problem or some times the inflammation can be vanished permanently during pregnancy.”

Source: skincarebeautyzone.com

Atopic dermatitis (AD) or eczema is one of the commonest skin diseases worldwide. It is more prevalent among women. Moreover, it is the most common skin condition during pregnancy, registering approximately between a third and a half of the total number of AD cases seen in dermatology clinics.

In fact, most women report the disease for the first time after they conceive. Barely 20-40% of women affected by eczema are estimated to have eczema before pregnancy. So that means 60-80% of all cases of eczema in women first occur during pregnancy. Moreover, three quarters of these women report indications within the first two trimesters of their pregnancy.

More than 50% of patients experience a deterioration of the syndrome during pregnancy (generally more during the second trimester), while only (approximately) 25% show improvement. Around 10 % of cases worsen in the postpartum period.

Therapy for atopic dermatitis during pregnancy

Though there are a variety of treatments available, pregnant women need to follow certain guidelines to prevent complications. The various forms of treatment and the associated course of action are as follows:

Treatment with topical corticosteroids

The mainstay of eczema treatment is the use of topical steroids combined with moisturizer-based emollients. The process involves taking tepid baths, applying the emollients and avoiding soap. However, one may need to seek a second line of treatment in case of severe eczema. This approach is also applicable in case of pregnant women but there are a few guidelines about their usage.

Mild or moderate topical corticosteroids combined with moisturizer-based emollients are the first line of treatment for mild to moderate eczema during pregnancy. Potent topical steroid creams are generally avoided for fear of systemic absorption into the blood and passage to the embryo.

Treatment with systemic corticosteroids

Systemic steroids are generally avoided since they can cause recurrence of flares when discontinued and may have side effects on early embryo development. Oral steroids are relatively safe during the third trimester. Though they might interfere with fetal growth, (mostly seen in asthma patients), there is no definite evidence whether it is caused by maternal disease or the oral steroids. However, for safety, most dermatologists will not use oral systemic steroids to treat eczema at any stage of pregnancy.

Systemic treatment is also not generally regarded as safe for lactating mothers as the corticosteroids will be present in the milk.

Narrowband Ultraviolet B

Narrowband ultraviolet B is the safest second line treatment during pregnancy, when topical steroids fail to manage the condition. It has been found to control acute episodes of the disease by over 30%. Ultraviolet B is also safe while breast-feeding.

Calcineurin inhibitors

It is comparatively safe to use topical calcineurin inhibitors (tacrolimus and pimecrolimus), but strictly in small amounts. It is used as a secondary therapy, but only if emollients and UV therapy has been ineffective. There is however a risk of intrauterine growth retardation. The application of the drugs is also limited to localised areas.

Other systemic treatments

If absolutely required, then the choices in systemic treatment begin with the use of immunosuppressive agents such as cyclosporin or azathioprine, but the condition of the patient and embryo must be closely monitored. Use of Azathioprine involves the risk of miscarriage, premature delivery and more rarely neonatal leucopenia, pancytopenia or inhibition of neonatal haematopoiesis.

Those undergoing systemic therapy must also keep a minimum time interval between discontinuing treatment to ensure a safe pregnancy and no harm to the newborn. Fetal growth retardation (though it may actually be caused by maternal diseases) is a risk factor in this group.

Methotrexate (another immunosuppressive agent) and psoralens plus ultraviolet A (PUVA) are best avoided during pregnancy and are unsuitable for lactating mothers.

Source: dermatitisfacts.com