Not only is it okay, but a warm bath can provide welcome relief from those late pregnancy aches and pains after a long day (and what day isn't long when you're eight months pregnant?). So hop-or rather, gingerly hoist yourself and your mountain of a belly-into the tub and enjoy a good soak.

If you're worried about bathwater entering your vagina (you may have heard that one through the pregnancy grapevine), don't be. Unless it's forced-as with douching or jumping into a pool, two things you shouldn't be doing anyway these days-water can't get where it shouldn't go. And even if a little water does make its way up, the cervical mucous plug that seals the entrance to the uterus effectively protects its precious contents from invading infectious organisms, should there be any floating around in your tub.

Even once you're in labor and the mucous plug is dislodged, you can still spend time in the bath. In fact, hydrotherapy during labor can provide welcome pain relief. You can even opt to give birth in a tub (see page 24 page 24).

One caveat when you're tubbing for two, especially this late in the pregnancy game: Make sure the tub has a nonslip surface or mat on the bottom so you don't take a tumble. And as always, avoid irritating bubble baths-as well as too-warm ones.

Driving Now "I can barely fit behind the wheel. Should I still be driving?"

You can stay in the driver's seat as long as you fit there; moving the seat back and tilting the wheel up will help with that. Assuming you've got the room-and you're feeling up to it-driving short distances is fine up until delivery day.

Car trips lasting more than an hour, however, might be too exhausting late in pregnancy, no matter who's driving. If you must take a longer trip, be sure to shift around in your seat frequently and to stop every hour or two to get up and walk around. Doing some neck and back stretches may also keep you more comfortable.

Don't, however, try to drive yourself to the hospital while in labor (a really strong contraction may prove dangerous on the road). And don't forget the most important road rule on any car trip, whether you are driver or passenger (and even if you're a passenger being driven to the hospital or birthing center in labor): Buckle up.

Traveling Now "I may have to make an important business trip this month. Is it safe for me to travel this late in pregnancy, or should I cancel?"

Before you schedule your trip, schedule a call or visit to your practitioner. Different practitioners have differing points of view on last-trimester travel. Whether yours will encourage you or discourage you from hitting the road-or the rails or the skies-at this point in your pregnancy will probably depend on that point of view, as well as on several other factors. Most important is the kind of pregnancy you've been having: You're more likely to get the green light if yours has been uncomplicated. How far along you are (most practitioners advise against flying after the 36th week) and whether you are at any increased risk at all for premature labor will weigh into the recommendation, too. Also very important is how you've been feeling. Pregnancy symptoms that multiply as the months pass also tend to multiply as the miles pass; traveling can lead to increased backache and fatigue, aggravated varicose veins and hemorrhoids, and added emotional and physical stress. Other considerations include how far and for how long you will be traveling (and how long you will actually be in transit), how demanding the trip will be physically and emotionally, as well as how necessary the trip is (optional trips or trips that can be easily postponed until well after delivery may not be worth making now). If you're traveling by air, you'll also need to factor in the restrictions-if any-of the airline you choose. Some will not let you travel in the ninth month without a letter from your practitioner affirming that you are not in imminent danger of going into labor while in flight; others are more lenient.

If your practitioner gives you the go-ahead, there are still plenty of other arrangements you'll need to make besides the travel ones. See page 250 page 250 for tips to ensure happy (and safer and more comfortable) trails for the pregnant you. Getting plenty of rest will be especially important. But most critical will be making sure you have the name, phone number, and address of a recommended practitioner (and the hospital or birthing center where he or she delivers) at your destination-one, of course, whose services will be covered by your insurance plan should you end up requiring them. If you're traveling a long distance, you may also want to consider the possibility of bringing along your spouse on the remote chance that if you do end up going into labor at your destination, at least you won't have to deliver without him. for tips to ensure happy (and safer and more comfortable) trails for the pregnant you. Getting plenty of rest will be especially important. But most critical will be making sure you have the name, phone number, and address of a recommended practitioner (and the hospital or birthing center where he or she delivers) at your destination-one, of course, whose services will be covered by your insurance plan should you end up requiring them. If you're traveling a long distance, you may also want to consider the possibility of bringing along your spouse on the remote chance that if you do end up going into labor at your destination, at least you won't have to deliver without him.

Making Love Now "I'm confused. I hear a lot of contradictory information about whether sex in the last weeks of pregnancy is safe-and whether it triggers labor."

It's not like there hasn't been a lot of research done about sex in late pregnancy. It's just that most of it is conflicting, leaving you and all your very pregnant peers unsure of how to proceed-that is, if you're still in the mood to proceed. It is widely believed that neither intercourse nor orgasm alone triggers labor unless conditions are ripe, though many impatient-to-deliver couples have enjoyed trying to prove otherwise. If conditions are ripe, it's been theorized, the prostaglandins in semen might be able to help get the labor party started. But even that's not a sure thing-or a theory you can necessarily bank on taking you to the birthing room, even under the right, ripe conditions. In fact, one study found that low-risk women who had sex in the final weeks of pregnancy actually carried their babies slightly longer than those who abstained from sex during that time. Are you confused yet?

Based on what's known, most physicians and midwives allow patients with normal pregnancies to make love right up until delivery day. And most couples apparently can do so without any problems arising, so to speak.

Check with your practitioner to see what the latest consensus is and what's safe in your situation. If you get a green light (chances are, you will), then by all means hit the sheets-if you have the will and the energy (and the gymnastic skills that might be necessary at this point). If the light is red (and it probably will be if you are at high risk for premature delivery, have placenta previa, or are experiencing unexplained bleeding), try getting intimate in other ways. While you still have some evenings to yourselves, rendezvous for a romantic candlelit dinner or a starlit stroll. Cuddle while you watch TV, or soap each other in the shower. Or use massage as the medium. Or do everything but-use your hands and your mouths to your heart's content, assuming your practitioner hasn't red-lighted orgasm for you. This may not quite satisfy like the real thing, but try to remember you have a whole lifetime of lovemaking ahead-though the pickings may continue to be slim in that department at least until baby's sleeping through the night.

Your Twosome "The baby isn't even born yet, and already my relationship with my husband seems to be changing. We're both so wrapped up in the birth and the baby, instead of in each other, the way we used to be."

Babies bring a lot of things when they arrive in a couple's lives-joy, excitement, and a lot of dirty diapers, for starters. But they also bring change-and considering they're only pint-size, they bring a whole bunch of change.

Not surprisingly, your relationship with your spouse is one place where you'll notice that change, and it sounds like you've glimpsed it already. And that's actually a really good thing. When baby makes three, your twosome is bound to undergo some shifting of dynamics and reshuffling of priorities. But this predictable upheaval is usually less stressful-and easier to adapt to-when a couple begins the natural and inevitable evolution of their relationship during pregnancy. In other words, the changes to your relationship are more likely to represent a change for the better if they begin before baby's arrival. Couples who don't anticipate at least some disruption of romance-as-usual-who don't realize that wine and roses will often give way to spit-up and strained carrots, that lovemaking marathons will place (well) behind baby-rocking marathons, that three's not always as cozy as two, at least not in the same way-often find the reality of life with a demanding newborn harder to handle.

So think ahead, plan ahead-and be ready for change. But as you get yourselves into nurture mode, don't forget that baby won't be the only one who'll need nurturing. As normal-and healthy-as it is to be wrapped up in the pregnancy and your expected extraspecial delivery, it's also important to reserve some emotional energy for the relationship that created that bundle of joy in the first place. Now is the time to learn to combine the care and feeding of your baby with the care and feeding of your marriage. While you're busily feathering your nest, make the effort to regularly reinforce romance. At least once a week, do something together that has nothing to do with childbirth or babies. See a movie, have dinner out, play miniature golf, hit the flea market. While you're out shopping for tiny onesies, buy a little something special (and unexpected) for your other special someone. Or surprise him with a pair of tickets for a show or a game you know he'd love to see. At dinner, spend at least some time asking about his day, talking about yours, discussing the day's headlines, reminiscing about your first date, dreaming about a second honeymoon (even if it won't be in the cards for many moons), all without mentioning the b-word. Bring massage oil to bed now and then, and rub each other the right way; even if you're not in the mood for sex-or it's seeming too much like hard work these days-any kind of touching can keep you close. None of this flame fanning will make the upcoming wonderful event any less anticipated, but it will remind you both that there's more to life than Lamaze and layettes.

Considering Cord Blood Banking As if you don't have enough to think about before baby's born, here's another decision you'll have to make: Should you save your baby's umbilical cord blood-and if so, how?Cord blood harvesting, a painless procedure that takes less than five minutes and is done after the cord has been clamped and cut, is completely safe for mother and child (as long as the cord is not clamped and cut prematurely). A newborn's cord blood contains stem cells that in some cases can be used to treat certain immune system disorders or blood diseases. And research is under way to determine if these stem cells can also be useful in treating other conditions, such as diabetes, cerebral palsey, even heart disease.There are two ways to store the blood: You can pay for private storage or you can donate the blood to a public storage bank. Private storage can be expensive, and the benefits for low-risk families-in other words, those who do not have any familial immune disorders-are not completely clear yet.For these reasons, ACOG recommends doctors present the pros and cons of cord blood banking, and the American Academy of Pediatrics (AAP) doesn't recommend private private cord blood storage unless a family member has a medical condition that might be helped by a stem cell transplant now or in the near future. These conditions include leukemia, lymphoma, and neuroblastoma; sickle cell anemia, aplastic anemia, and thalassemia illness; Gaucher disease and Hurler syndrome; Wiskott-Aldrich syndrome; and severe hemoglobinopathy. The AAP does, however, support parents donating the cord blood to a bank for general use by the public. This costs the donor nothing and could save a life. cord blood storage unless a family member has a medical condition that might be helped by a stem cell transplant now or in the near future. These conditions include leukemia, lymphoma, and neuroblastoma; sickle cell anemia, aplastic anemia, and thalassemia illness; Gaucher disease and Hurler syndrome; Wiskott-Aldrich syndrome; and severe hemoglobinopathy. The AAP does, however, support parents donating the cord blood to a bank for general use by the public. This costs the donor nothing and could save a life.Investigate your family's medical history to see if private cord blood banking makes sense for you. Or if you feel the potential future benefits are worth the cost, no matter what your family history, sign up for private banking (see below). You can also talk the cord blood options over with your practitioner.For general information on cord blood banking, visit parentsguidecordblood.com. For information on donating cord blood, contact the International Cord Blood Registry at (650) 635-1452, cordblooddonor.org; or the National Marrow Donor Program at (800) MARROW2 (627-7692), marrow.org. For private banking options, contact the Cord Blood Registry at (888) 932-6568, cordblood.com; or ViaCord at (877) 535-4148, viacord.com.

Breastfeeding For the past 30-odd weeks, you've likely seen (and felt) your breasts grow ... and grow ... and grow. If you've given any thought to what's going on underneath those giant cups you've now traded up for, you probably know that your breasts aren't growing randomly but are gearing up for one of nature's most important jobs: baby feeding.

It's clear that your breasts are already on board with breastfeeding. Whether you are, too, or whether you're still weighing your baby-feeding options, you'll probably want to learn more about this amazing process, a process that turns breasts (your breasts!) into the perfect purveyors of the world's most perfect infant food. You'll get some valuable highlights and insights here, but for much more on breastfeeding (from the why-to's to the how-to's), see What to Expect the First Year. What to Expect the First Year.

Why Breast Is Best Just as goat's milk is the ideal food for kids (goat kids, that is), and cow's milk is the best meal for young calves, your human breast milk is the perfect meal for your human newborn. Here are the reasons why: It's custom-made. Tailored to meet the nutritional needs of human infants, breast milk contains at least 100 ingredients that aren't found in cow's milk and that can't be precisely replicated in commercial formulas. The protein in breast milk is mostly lactalbumin, which is more nutritious and digestible than the major protein component of cow's milk, caseinogen, which is what formula is made from. The amount of fat in the two milks is similar, but the fat in mother's milk is more easily broken down and used by a baby. Infants also have an easier time absorbing the important micronutrients in breast milk than in cow's milk. Tailored to meet the nutritional needs of human infants, breast milk contains at least 100 ingredients that aren't found in cow's milk and that can't be precisely replicated in commercial formulas. The protein in breast milk is mostly lactalbumin, which is more nutritious and digestible than the major protein component of cow's milk, caseinogen, which is what formula is made from. The amount of fat in the two milks is similar, but the fat in mother's milk is more easily broken down and used by a baby. Infants also have an easier time absorbing the important micronutrients in breast milk than in cow's milk.

It's safe. You can be sure that the milk served up directly from your breast isn't improperly prepared, contaminated, tampered with, or spoiled. It never gets pulled from the shelves or overstays its sell-by date.

It's a tummy soother. Nursed babies are almost never constipated, thanks to the easier digestibility of breast milk. They also rarely have diarrhea, since breast milk seems both to destroy some diarrhea-causing organisms and to encourage the growth of beneficial flora in the digestive tract, which further discourage digestive upset. On a purely aesthetic note, the bowel movements of a breastfed baby are sweeter smelling (at least until solids are introduced). They're also less apt to cause diaper rash.

It's a fat flattener. Not only is breastfeeding less likely to cause overweight infants, but having been nursed for at least six months (or better, at least a year) appears to be related to lower rates of obesity later in life. It may also be linked to lower cholesterol readings in adulthood. Not only is breastfeeding less likely to cause overweight infants, but having been nursed for at least six months (or better, at least a year) appears to be related to lower rates of obesity later in life. It may also be linked to lower cholesterol readings in adulthood.

It's a brain booster. Breastfeeding appears to slightly increase a child's IQ. This may be related not only to the brain-building fatty acids (DHA) it contains, but to the closeness and mother-baby interaction that is built into breastfeeding, which naturally fosters intellectual development. Breastfeeding appears to slightly increase a child's IQ. This may be related not only to the brain-building fatty acids (DHA) it contains, but to the closeness and mother-baby interaction that is built into breastfeeding, which naturally fosters intellectual development.

It keeps allergies on hold. Virtually no baby is allergic to breast milk (though once in a while an infant can have an allergic reaction to a certain food or foods in mom's diet, including cow's milk). On the other hand, beta-lactoglobulin, a substance contained in cow's milk, can trigger an allergic response, with a variety of possible symptoms ranging from mild to severe. Soy milk formulas, which are often substituted when an infant is allergic to cow's milk, stray even further in composition from what nature intended and can also cause an allergic reaction. Studies show, too, that breastfed infants are less likely to get childhood asthma than those babies fed formula.

It's an infection preventer. Breastfed babies are less subject not only to diarrhea but to infections of all kinds-including UTIs and ear infections. In fact, a number of studies suggest that a very wide range of diseases may be somewhat lower in breastfed children, including bacterial meningitis, SIDS, diabetes, some childhood cancers, Crohn's disease, and other chronic digestive diseases. Protection is partially provided by the transfer of immune factors in breast milk and in the premilk substance, colostrum. Breastfed babies are less subject not only to diarrhea but to infections of all kinds-including UTIs and ear infections. In fact, a number of studies suggest that a very wide range of diseases may be somewhat lower in breastfed children, including bacterial meningitis, SIDS, diabetes, some childhood cancers, Crohn's disease, and other chronic digestive diseases. Protection is partially provided by the transfer of immune factors in breast milk and in the premilk substance, colostrum.

It builds stronger mouths. Because nursing at the breast requires more effort than sucking on a bottle, breastfeeding may encourage optimum development of jaws, teeth, and palate. Also, recent studies show that babies who are breastfed are less likely to get cavities later on in childhood than those who are not. Because nursing at the breast requires more effort than sucking on a bottle, breastfeeding may encourage optimum development of jaws, teeth, and palate. Also, recent studies show that babies who are breastfed are less likely to get cavities later on in childhood than those who are not.

It expands the taste buds early on. Want to raise an adventurous eater? Start at the breast. Developing those little taste buds on breast milk, which takes on the flavor of whatever you've been eating, may acclimate a baby early on to a world of flavors. Researchers have found that nursed babies are less likely to be timid in their tastes than their formula-fed peers once they graduate to the high chair-which means they may be more likely to open wide to that spoonful of yams (or that forkful of curried chicken) later on.

Breastfeeding offers a pile of perks for Mom, too: Convenience. Breastfeeding requires no advance planning, packing, or equipment; it's always available (at the park, on an airplane, in the middle of the night), at just the right temperature. When you're nursing, you can pack up the baby and hit the road without having to pack up and lug around bottles, nipples, cleaning supplies, and so on; your breasts will always come along for the ride (you can't forget to pack them). You can also skip 2 a.m. trips to the kitchen for a formula refill; late-night feedings require nothing more complicated than an easy-access nightie and a cozy, sleepy snuggle with your little one. When you and baby aren't together (if you work outside the home, for instance), milk can be expressed in advance and stored in the freezer for bottle-feedings as needed. Breastfeeding requires no advance planning, packing, or equipment; it's always available (at the park, on an airplane, in the middle of the night), at just the right temperature. When you're nursing, you can pack up the baby and hit the road without having to pack up and lug around bottles, nipples, cleaning supplies, and so on; your breasts will always come along for the ride (you can't forget to pack them). You can also skip 2 a.m. trips to the kitchen for a formula refill; late-night feedings require nothing more complicated than an easy-access nightie and a cozy, sleepy snuggle with your little one. When you and baby aren't together (if you work outside the home, for instance), milk can be expressed in advance and stored in the freezer for bottle-feedings as needed.

Economy. Breast milk is free, and so is its delivery system. Breast milk is free, and so is its delivery system.

Speedy recovery. When baby sucks on your breasts, it triggers the release of the hormone oxytocin, which helps speed the shrinking of the uterus back to its prepregnant size and may decrease the flow of lochia (postpartum vaginal bleeding), which means less blood loss. Nursing also enforces rest periods for you-particularly important, as you'll discover, during the first six postpartum weeks. When baby sucks on your breasts, it triggers the release of the hormone oxytocin, which helps speed the shrinking of the uterus back to its prepregnant size and may decrease the flow of lochia (postpartum vaginal bleeding), which means less blood loss. Nursing also enforces rest periods for you-particularly important, as you'll discover, during the first six postpartum weeks.

Speedy return to prepregnancy shape. And speaking of shrinking, all those extra calories your baby is draining out of you means that even though you'll be adding more calories to your diet to make milk, you won't be piling on the pounds-and you might start seeing that waistline of yours sooner. And speaking of shrinking, all those extra calories your baby is draining out of you means that even though you'll be adding more calories to your diet to make milk, you won't be piling on the pounds-and you might start seeing that waistline of yours sooner.

Prepping for Breastfeeding Luckily, nature has worked out all the details, so there's not much you'll need to do to get ready for breastfeeding while you're still expecting (other than read up as much as you can). Some lactation experts recommend that during the last months of pregnancy you skip the soap on your nipples and areolas-just rinse with water, instead (it's not like they get that dirty, anyway). Soap tends to dry the nipples, which may lead to cracking and soreness early in breastfeeding. If your breasts are dry or itchy, a mild cream or lotion may feel soothing, but avoid getting it on the nipple or areola. If your nipples are dry, you can apply a lanolin-based cream such as Lansinoh.The no-prep-necessary rule applies even to women with small or flat nipples. Flat nipples don't need to be prepped for nursing with breast shells, hand manipulation, or a manual breast pump during pregnancy. Not only are these prepping techniques often less effective than no treatment, but they can do more harm than good. The shells, besides being embarrassingly conspicuous, can cause sweating and rashes. Hand manipulation and pumping can stimulate contractions and, occasionally, even trigger breast infection.One possible exception: You may want to think about planning ahead if your nipples are inverted (in other words, they retract when you squeeze the areola), which can make nursing a little trickier. Breast shells may help draw nipples out, but you probably won't want to use them frequently, for the reasons above. Ask your practitioner for the name of a lactation consultant who may be able to advise you, or contact your local La Leche League.

Period postponement. Your period will be slower to return, and who could complain about that? But unless you want your children very closely spaced-or enjoy surprises-you should not not rely on breastfeeding as your only form of contraception. Most mothers who exclusively breastfeed-and whose babies are not sucking often on pacifiers-are probably protected for a few postpartum months. But they can begin menstruating as early as four months after giving birth and may be fertile before that first period. rely on breastfeeding as your only form of contraception. Most mothers who exclusively breastfeed-and whose babies are not sucking often on pacifiers-are probably protected for a few postpartum months. But they can begin menstruating as early as four months after giving birth and may be fertile before that first period.

Bone building. Nursing can improve mineralization in your bones after weaning and may reduce the risk of hip fracture after menopause, assuming you're taking in enough calcium to fill your needs and milk-making requirements.

Health benefits. Feeding your baby via the breast can reduce your risk of some cancers down the road. Women who breastfeed have a lower risk of developing ovarian cancer and breast cancer. Nursing also seems to reduce your risk of developing type 2 diabetes.

The biggest and best bonus. Breastfeeding brings you and your baby together, skin to skin, eye to eye, at least six to eight times a day. The emotional gratification, the intimacy, the sharing of love and pleasure, can not only be very fulfilling and make for a strong mother-child relationship, but it may also enhance your baby's brain development. (A note to mothers of twins: All the advantages of breastfeeding are doubled for you. See page 447 page 447 for tips on tandem breastfeeding.) for tips on tandem breastfeeding.)

The Breast: Sexual or Practical?

Or can it be both? If you think about it, having two or even more roles in life is not unusual-even roles that are very different, that require different skill sets and different attitudes (lover and mother, for example). You can look at the different roles of the breast-one sexual and one practical-in the same way: Each is important; neither is mutually exclusive. You can have one and the other, too (and in fact, breastfeeding makes lots of women-and their partners-feel especially sensuous). In deciding whether or not to breastfeed, keep this in mind.

For more information on breastfeeding, contact your local La Leche League, (800) La Leche (525-3243), or visit LLLUSA.org.

Why Some Opt for the Bottle Maybe you've decided that breastfeeding definitely isn't for you. Or maybe there's a reason you won't be able to breastfeed, at least not exclusively. Don't feel guilty about choosing the bottle over the breast (or even combining the two; see page 336 page 336). Here are some of the pros of bottle-feeding: More shared responsibility. Bottle-feeding allows dad to share the feeding responsibilities and its bonding benefits more easily. (Although the father of a breastfed baby can derive the same benefits, assuming his baby will take a bottle at all, by feeding a bottle of expressed mother's milk, as well as by taking charge of other baby-care activities, such as bathing, changing, and rocking.) Bottle-feeding allows dad to share the feeding responsibilities and its bonding benefits more easily. (Although the father of a breastfed baby can derive the same benefits, assuming his baby will take a bottle at all, by feeding a bottle of expressed mother's milk, as well as by taking charge of other baby-care activities, such as bathing, changing, and rocking.) More freedom. Bottle-feeding doesn't tie a mom down to her baby. She's able to work outside the home without worrying about pumping and storing milk. She can travel a few days without the baby, even sleep through the night, because someone else can feed her baby. (Of course, these options are also open to breastfeeding moms who express milk or supplement with formula.) Potentially, more romance. Bottle-feeding doesn't interfere with a couple's sex life (except when baby wakes up for a feeding at the wrong time). Breastfeeding can, to some extent. First, because lactation hormones can keep the vagina relatively dry (though vaginal lubricants can remedy the problem); and second, because leaky breasts during lovemaking can be a cold shower for some couples. For bottle-feeding couples, the breasts can play their strictly sensual role rather than their utilitarian one.

Fewer limitations on your diet. Bottle-feeding doesn't cramp your eating style. You can eat all the spicy foods and cabbage you want (though many babies don't object to these tastes in breast milk, and some actually lap them up), you can have a daily glass of wine or a cocktail without factoring in the next feeding, and you don't have to worry about as many nutritional requirements.

No public displays. If you're uncomfortable about the possibility of nursing in public, breastfeeding may be hard to imagine. That hangup, though, is often quickly hung up; many women who opt to try breastfeeding soon find it becomes second nature (and easy to accomplish discreetly), even in the most public places.

Less stress. Some women worry that they're too impatient or tense by nature to breastfeed. Given a try, you may find, however, that nursing is actually very relaxing: a stress-buster, not a stress-inducer (at least once it's well established). Some women worry that they're too impatient or tense by nature to breastfeed. Given a try, you may find, however, that nursing is actually very relaxing: a stress-buster, not a stress-inducer (at least once it's well established).

Making the Choice to Breastfeed For more and more women today, the choice is clear. Some know they'll opt for breast over bottle long before they even decide to become pregnant. Others, who never gave it much thought before pregnancy, choose breastfeeding once they've read up on its many benefits. Some women teeter on the brink of indecision right through pregnancy and even delivery. A few women, convinced that nursing isn't for them, still can't shake the nagging feeling that they ought to do it anyway.

Undecided? Here's a suggestion: Try it-you may like it. You can always quit if you don't, but at least you will have cleared up those nagging doubts. Best of all, you and your baby will have reaped some of the most important benefits of breastfeeding, if only for a brief time.

Nursing After Breast Surgery Many women who have had breast reductions are able to breastfeed, though most don't produce enough milk to nurse exclusively. Whether you will be able to breastfeed your baby-and how much you'll need to supplement your milk supply with formula-will depend at least in part on how the procedure was performed. Check with your surgeon. If care was taken to preserve milk ducts and nerve pathways, chances are good that you'll be able to produce at least some milk. (The same applies if you had breast surgery because of breast cancer or because of fibrocystic breasts.)If your surgeon is reassuring, increase your chances of success by reading up on breastfeeding and working with a lactation consultant who is familiar with the challenges of nursing after a breast reduction. Closely monitoring your baby's intake (by keeping an eye on growth and the number of dirty and wet diapers) will be especially important. If you don't end up making enough milk, supplement with bottles of formula (do the combo). Also consider using a nursing supplementation system, which allows you to breastfeed and supplement with formula at the same time and can encourage milk production while ensuring that your baby gets enough to eat. Remember, any amount of breastfeeding-even if it doesn't turn out to be baby's only or even primary source of nutrition-is beneficial. Visit bfar.org for more information on breastfeeding after reduction.Breast augmentation is far less likely to interfere with breastfeeding than a breast reduction, but it depends on the technique, the incision, and the reason why it was done. While many women with implants are able to nurse exclusively, a significant minority may not produce enough milk. To make sure your supply meets your baby's demand, you'll need to keep close tabs on his or her growth and the number of dirty and wet diapers accumulated daily.

Got Pierced?

You're all set to nurse your baby-to-be, but there's one wrinkle-or rather, one ring, or one stud-that you're not sure what to do with. If you have a nipple piercing, good news: No evidence shows that nipple piercing has any effect on a woman's ability to breastfeed. But experts (in both the lactation and the piercing businesses) agree that you should remove any nipple jewelry before you nurse your baby. This is not only due to the potential for infection for you; it's also because the jewelry could pose a choking hazard for your baby or injure his or her tender gums, tongue, or palate during feedings.

But do be sure to give breastfeeding a fair trial. The first few weeks can be challenging, even for the most enthusiastic breastfeeders, and are always a learning process (though getting help from a lactation consultant or a sister or friend who has breastfed could make things easier if you're having a hard time). A full month, or even six weeks, of nursing is generally needed to establish a successful feeding relationship and give a mom the chance to figure out whether breast is best for her.

Mixing Breast and Bottle Some women who choose to breastfeed find-for one reason or another-that they can't or don't want to do it exclusively. Maybe exclusive breastfeeding doesn't turn out to be practical in the context of their lifestyle (too many business trips away from home or a job that otherwise makes pumping a logistical nightmare). Maybe it proves to be too physically challenging. Fortunately, neither breastfeeding nor bottle-feeding is an all-or-nothing proposition-and for some women, combining the two is a compromise that works. If you choose to do the combo, keep in mind that you'll need to wait until breastfeeding is well established (at least two to three weeks) before introducing formula. For more information on combining breast and bottle, see What to Expect the First Year. What to Expect the First Year.

When You Can't or Shouldn't Breastfeed Unfortunately, the option of breastfeeding isn't open to every new mother. Some women can't or shouldn't nurse their newborns. The reasons may be emotional or physical, due to the mother's health or the baby's, temporary (in which case breastfeeding can sometimes begin later on) or long term. The most common maternal factors that may prevent or interfere with breastfeeding include: [image] Serious debilitating illness (such as cardiac or kidney impairment, or severe anemia) or extreme underweight, though some women manage to overcome the obstacles and breastfeed their babies. Serious debilitating illness (such as cardiac or kidney impairment, or severe anemia) or extreme underweight, though some women manage to overcome the obstacles and breastfeed their babies.[image] Serious infection, such as active untreated tuberculosis; during treatment, breasts can be pumped so a supply will be established once breastfeeding resumes. Serious infection, such as active untreated tuberculosis; during treatment, breasts can be pumped so a supply will be established once breastfeeding resumes.[image] Chronic conditions that require medications that pass into the breast milk and might be harmful to the baby, such as antithyroid, anticancer, or antihypertensive drugs or mood-altering drugs, such as lithium, tranquilizers, or sedatives. If you take any kind of medication, check with your physician if you're considering breastfeeding. In some cases, a change of medication or spacing of doses may make breastfeeding possible. A temporary need for medication, such as penicillin, even at the time you begin nursing, doesn't usually have to interfere with breastfeeding. Women who need antibiotics during labor or due to a breast infection (mastitis) can continue to breastfeed while on the medication. Chronic conditions that require medications that pass into the breast milk and might be harmful to the baby, such as antithyroid, anticancer, or antihypertensive drugs or mood-altering drugs, such as lithium, tranquilizers, or sedatives. If you take any kind of medication, check with your physician if you're considering breastfeeding. In some cases, a change of medication or spacing of doses may make breastfeeding possible. A temporary need for medication, such as penicillin, even at the time you begin nursing, doesn't usually have to interfere with breastfeeding. Women who need antibiotics during labor or due to a breast infection (mastitis) can continue to breastfeed while on the medication.[image] Exposure to certain toxic chemicals in the workplace; check with OSHA (see Exposure to certain toxic chemicals in the workplace; check with OSHA (see page 194 page 194).[image] Alcohol abuse. An occasional drink is okay, but too much alcohol can cause problems for a nursing baby. Alcohol abuse. An occasional drink is okay, but too much alcohol can cause problems for a nursing baby.[image] Drug abuse, including the use of tranquilizers, cocaine, heroin, methadone, or marijuana. Drug abuse, including the use of tranquilizers, cocaine, heroin, methadone, or marijuana.[image] AIDS, or HIV infection, which can be transmitted via body fluids, including breast milk. AIDS, or HIV infection, which can be transmitted via body fluids, including breast milk.

Some conditions in the newborn may make breastfeeding difficult, but not (with the right lactation support) impossible. They include: [image] A premature or very small baby, who may have difficulty sucking or latching on properly. A preemie who is sick and has to spend time in the NICU (neonatal intensive care unit) also may not be able to nurse, though you can pump to establish a good milk supply and feed the breast milk to the baby with the help of the hospital staff. A premature or very small baby, who may have difficulty sucking or latching on properly. A preemie who is sick and has to spend time in the NICU (neonatal intensive care unit) also may not be able to nurse, though you can pump to establish a good milk supply and feed the breast milk to the baby with the help of the hospital staff.[image] Disorders such as lactose intolerance or PKU in which neither human nor cow's milk can be digested. In the case of PKU, babies can be breastfed if they also receive supplemental phenylalanine free formula; with lactose intolerance (which is extremely rare at birth), mother's milk can be treated with lactase to make it digestible. Disorders such as lactose intolerance or PKU in which neither human nor cow's milk can be digested. In the case of PKU, babies can be breastfed if they also receive supplemental phenylalanine free formula; with lactose intolerance (which is extremely rare at birth), mother's milk can be treated with lactase to make it digestible.

When Father Knows Breast It only takes two to breastfeed, but it often takes three to make it happen. Researchers have found that when fathers are supportive of breastfeeding, moms are likely to give it a try 96 percent of the time; when dads are ambivalent, only about 26 percent give it a try. What's more, say researchers, keeping dad in the breastfeeding loop (by providing him with lots of nursing know-how so he can better support you) can help extend the length of time you end up breastfeeding-plus it could make nursing easier overall. Dads: Take note, and join the breastfeeding team!

[image]Cleft lip or other mouth deformities that interfere with sucking. Though the success of breastfeeding depends somewhat on the type of defect, with special help, nursing is usually possible. (Babies with cleft palates won't be able to breastfeed but will still be able to be fed pumped breast milk.) Very rarely, the milk supply isn't adequate, perhaps because of insufficient glandular tissue in the breast, and breastfeeding just doesn't work-no matter how hard mother and baby work at it.

If you end up not being able to nurse your baby-even if you very much wanted to-there's no reason to add guilt to your disappointment. In fact, it's important that you don't, to avoid letting those feelings interfere with the very important process of getting to know and love your baby-a process that by no means must include breastfeeding.

CHAPTER 14.

The Ninth Month Approximately 36 to 40 Weeks FINALLY. THE MONTH YOU'VE BEEN waiting for, working toward, and possibly worrying about just a little bit is here at long last. Chances are you're at once very ready (to hold that baby ... to see your toes again ... to sleep on your stomach!) and not ready at all. Still, despite the inevitable flurry of activity (more practitioner appointments, a layette to shop for, projects to finish at work, paint colors to pick for baby's room), you may find that the ninth month seems like the longest month of all. Except, of course, if you don't deliver by your due date. In that case, it's the tenth month that's the longest. waiting for, working toward, and possibly worrying about just a little bit is here at long last. Chances are you're at once very ready (to hold that baby ... to see your toes again ... to sleep on your stomach!) and not ready at all. Still, despite the inevitable flurry of activity (more practitioner appointments, a layette to shop for, projects to finish at work, paint colors to pick for baby's room), you may find that the ninth month seems like the longest month of all. Except, of course, if you don't deliver by your due date. In that case, it's the tenth month that's the longest.

Your Baby This Month Week 36 Weighing about 6 pounds and measuring somewhere around 20 inches tall, your baby is almost ready to be served up into your arms. Right now, most of baby's systems (from circulatory to musculoskeletal) are just about equipped for life on the outside. Though the digestive system is ready to roll, too, it hasn't really gotten a workout yet. Remember, up until this point, your baby's nutrition has been arriving via the umbilical cord-no digestion necessary. But that's soon to change. As soon as baby takes his or her first suckle at your breast (or suck from the bottle), that digestive system will be jump-started-and those diapers will start filling. Weighing about 6 pounds and measuring somewhere around 20 inches tall, your baby is almost ready to be served up into your arms. Right now, most of baby's systems (from circulatory to musculoskeletal) are just about equipped for life on the outside. Though the digestive system is ready to roll, too, it hasn't really gotten a workout yet. Remember, up until this point, your baby's nutrition has been arriving via the umbilical cord-no digestion necessary. But that's soon to change. As soon as baby takes his or her first suckle at your breast (or suck from the bottle), that digestive system will be jump-started-and those diapers will start filling.

Week 37 Here's some exciting news: If your baby were born today, he or she would be considered full term. Mind you, that doesn't mean he or she is finished growing-or getting ready for life on the outside. Still gaining weight at about a half pound a week, the average fetus this age weighs about 6 pounds (though size varies quite a bit from fetus to fetus, as it does from newborn to newborn). Fat continues to accumulate on your baby, forming kissable dimples in those cute elbows, knees, and shoulders, and adorable creases and folds in the neck and wrists. To keep busy until the big debut, your baby is practicing to make perfect: inhaling and exhaling amniotic fluid (to get the lungs ready for that first breath), sucking on his or her thumb (to prepare for that first suckle), blinking, and pivoting from side to side (which explains why yesterday you felt that sweet little butt on the left side and today it's taken a turn to the right). Here's some exciting news: If your baby were born today, he or she would be considered full term. Mind you, that doesn't mean he or she is finished growing-or getting ready for life on the outside. Still gaining weight at about a half pound a week, the average fetus this age weighs about 6 pounds (though size varies quite a bit from fetus to fetus, as it does from newborn to newborn). Fat continues to accumulate on your baby, forming kissable dimples in those cute elbows, knees, and shoulders, and adorable creases and folds in the neck and wrists. To keep busy until the big debut, your baby is practicing to make perfect: inhaling and exhaling amniotic fluid (to get the lungs ready for that first breath), sucking on his or her thumb (to prepare for that first suckle), blinking, and pivoting from side to side (which explains why yesterday you felt that sweet little butt on the left side and today it's taken a turn to the right).

Your Baby, Month 9 Week 38 Hitting the growth charts at close to 7 pounds and the 20-inch mark (give or take an inch or two), your little one isn't so little anymore. In fact, baby's big enough for the big time-and the big day. With only two (or four, max) weeks left in utero, all systems are (almost) go. To finish getting ready for his or her close-up (and all those photo ops), baby has a few last-minute details to take care of, like shedding that skin-protecting vernix and lanugo. And producing more surfactant, which will prevent the air sacs in the lungs from sticking to each other when your baby begins to breathe-something he or she will be doing very soon. Baby will be here before you know it! Hitting the growth charts at close to 7 pounds and the 20-inch mark (give or take an inch or two), your little one isn't so little anymore. In fact, baby's big enough for the big time-and the big day. With only two (or four, max) weeks left in utero, all systems are (almost) go. To finish getting ready for his or her close-up (and all those photo ops), baby has a few last-minute details to take care of, like shedding that skin-protecting vernix and lanugo. And producing more surfactant, which will prevent the air sacs in the lungs from sticking to each other when your baby begins to breathe-something he or she will be doing very soon. Baby will be here before you know it!

Week 39 Not much to report this week, at least in the height and weight department. Fortunately for you and your overstretched skin (and aching back), baby's growth has slowed down-or even taken a hiatus until after delivery. On average, a baby this week still weighs in at around 7 or 8 pounds and measures up at 19 to 21 inches (though yours may be a little bigger or smaller). Still, progress is being made in some other areas, especially baby's brain, which is growing and developing up a storm (at a rapid pace that will continue during the first three years of life). What's more, your baby's pink skin has turned white or whitish (no matter what skin your baby will ultimately be in, since pigmentation doesn't occur until soon after birth). A development that you may have noticed by now if this is your first pregnancy: Baby's head might have dropped into your pelvis. This change of baby's locale might make for easier breathing (and less heartburn), but could also make it harder for you to walk (make that to waddle). Not much to report this week, at least in the height and weight department. Fortunately for you and your overstretched skin (and aching back), baby's growth has slowed down-or even taken a hiatus until after delivery. On average, a baby this week still weighs in at around 7 or 8 pounds and measures up at 19 to 21 inches (though yours may be a little bigger or smaller). Still, progress is being made in some other areas, especially baby's brain, which is growing and developing up a storm (at a rapid pace that will continue during the first three years of life). What's more, your baby's pink skin has turned white or whitish (no matter what skin your baby will ultimately be in, since pigmentation doesn't occur until soon after birth). A development that you may have noticed by now if this is your first pregnancy: Baby's head might have dropped into your pelvis. This change of baby's locale might make for easier breathing (and less heartburn), but could also make it harder for you to walk (make that to waddle).

Week 40 Congratulations! You've reached the official end of your pregnancy (and perhaps the end of your rope). For the record, your baby is fully full term and could weigh in anywhere between the 6- and 9-pound mark and measure anywhere from 19 to 22 inches, though some perfectly healthy babies check in smaller or bigger than that. You may notice when your baby emerges that he or she (and you'll know for sure at that momentous moment which) is still curled into the fetal position, even though the fetal days are over. That's just sheer force of habit (after spending nine months in the cramped confines of your uterus, your baby doesn't yet realize there's room to spread out now) and comfort (that snug-as-a-bug position feels good). When you do meet your new arrival, be sure to say hello-and more. Though it's your first face-to-face, your baby will recognize the sound of your voice-and that of dad's. And if he or she doesn't arrive on time (choosing to ignore the due date you've marked in red on your calendar), you're in good-though anxious-company. About half of all pregnancies proceed past the 40-week mark, though, thankfully, your practitioner will probably not let yours continue beyond 42 weeks. Congratulations! You've reached the official end of your pregnancy (and perhaps the end of your rope). For the record, your baby is fully full term and could weigh in anywhere between the 6- and 9-pound mark and measure anywhere from 19 to 22 inches, though some perfectly healthy babies check in smaller or bigger than that. You may notice when your baby emerges that he or she (and you'll know for sure at that momentous moment which) is still curled into the fetal position, even though the fetal days are over. That's just sheer force of habit (after spending nine months in the cramped confines of your uterus, your baby doesn't yet realize there's room to spread out now) and comfort (that snug-as-a-bug position feels good). When you do meet your new arrival, be sure to say hello-and more. Though it's your first face-to-face, your baby will recognize the sound of your voice-and that of dad's. And if he or she doesn't arrive on time (choosing to ignore the due date you've marked in red on your calendar), you're in good-though anxious-company. About half of all pregnancies proceed past the 40-week mark, though, thankfully, your practitioner will probably not let yours continue beyond 42 weeks.

Weeks 4142 Looks like baby has opted for a late checkout. Fewer than 5 percent of babies are actually born on their due date-and around 50 percent decide to overstay their welcome in Hotel Uterus, thriving well into the tenth month (though you may have lost that "thriving" feeling long ago). Remember, too, that most of the time an overdue baby isn't overdue at all-it's just that the due date was off. Less often, a baby may be truly postmature. When a postmature baby does make a debut, it's often with dry, cracked, peeling, loose, and wrinkled skin (all completely temporary). That's because the protective vernix was shed in the weeks before, in anticipation of a delivery date that's since come and gone. An "older" fetus will also have longer nails, possibly longer hair, and definitely little or none of that baby fuzz (lanugo) at all. They are also more alert and open-eyed (after all, they're older and wiser). Just to be sure all is well, your practitioner will likely monitor an overdue baby closely through nonstress tests and checks of the amniotic fluid or biophysical profiles. Looks like baby has opted for a late checkout. Fewer than 5 percent of babies are actually born on their due date-and around 50 percent decide to overstay their welcome in Hotel Uterus, thriving well into the tenth month (though you may have lost that "thriving" feeling long ago). Remember, too, that most of the time an overdue baby isn't overdue at all-it's just that the due date was off. Less often, a baby may be truly postmature. When a postmature baby does make a debut, it's often with dry, cracked, peeling, loose, and wrinkled skin (all completely temporary). That's because the protective vernix was shed in the weeks before, in anticipation of a delivery date that's since come and gone. An "older" fetus will also have longer nails, possibly longer hair, and definitely little or none of that baby fuzz (lanugo) at all. They are also more alert and open-eyed (after all, they're older and wiser). Just to be sure all is well, your practitioner will likely monitor an overdue baby closely through nonstress tests and checks of the amniotic fluid or biophysical profiles.

What You May Be Feeling You may experience all of these symptoms at one time or another, or only a few of them. Some may have continued from last month; others may be new. Still others may hardly be noticed because you are used to them and/or because they are eclipsed by new and more exciting signs indicating that labor may not be far off:

A Look Inside Your uterus is right under your ribs now, and your measurements aren't really changing that much from week to week anymore. The top of your uterus is around 38 to 40 cm from the top of your pubic bone. Your weight gain slows down or even stops as D-day approaches. Your abdominal skin is stretched as far as you think it can go, and you're probably waddling more now than ever, possibly because the baby has dropped in anticipation of impending labor.

Physically [image] Changes in fetal activity (more squirming and less kicking, as your baby has progressively less room to move around) Changes in fetal activity (more squirming and less kicking, as your baby has progressively less room to move around)[image] Vaginal discharge becomes heavier and contains more mucus, which may be streaked red with blood or tinged brown or pink after intercourse or a pelvic exam or as your cervix begins to dilate Vaginal discharge becomes heavier and contains more mucus, which may be streaked red with blood or tinged brown or pink after intercourse or a pelvic exam or as your cervix begins to dilate[image] Constipation Constipation[image] Heartburn, indigestion, flatulence, bloating Heartburn, indigestion, flatulence, bloating[image] Occasional headaches, faintness, dizziness Occasional headaches, faintness, dizziness[image] Nasal congestion and occasional nosebleeds; ear stuffiness Nasal congestion and occasional nosebleeds; ear stuffiness[image] Sensitive gums Sensitive gums[image] Leg cramps at night Leg cramps at night[image] Increased backache and heaviness Increased backache and heaviness[image] Buttock and pelvic discomfort and achiness Buttock and pelvic discomfort and achiness[image] Increased swelling of ankles and feet, and occasionally of hands and face Increased swelling of ankles and feet, and occasionally of hands and face[image] Itchy abdomen, protruding navel Itchy abdomen, protruding navel[image] Stretch marks Stretch marks[image] Varicose veins in your legs Varicose veins in your legs[image] Hemorrhoids Hemorrhoids[image] Easier breathing after the baby drops Easier breathing after the baby drops[image] More frequent urination after the baby drops, since there's pressure on the bladder once again More frequent urination after the baby drops, since there's pressure on the bladder once again[image] Increased difficulty sleeping Increased difficulty sleeping[image] More frequent and more intense Braxton Hicks contractions (some may be painful) More frequent and more intense Braxton Hicks contractions (some may be painful)[image] Increasing clumsiness and difficulty getting around Increasing clumsiness and difficulty getting around[image] Colostrum, leaking from nipples (though this premilk substance may not appear until after delivery) Colostrum, leaking from nipples (though this premilk substance may not appear until after delivery)[image] Extra fatigue or extra energy (nesting syndrome), or alternating periods of each Extra fatigue or extra energy (nesting syndrome), or alternating periods of each[image] Increase in appetite or loss of appetite Increase in appetite or loss of appetite Emotionally [image] More excitement, more anxiety, more apprehension, more absentmindedness More excitement, more anxiety, more apprehension, more absentmindedness[image] Relief that you're almost there Relief that you're almost there[image] Irritability and oversensitivity (especially with people who keep saying "Are you still around?") Irritability and oversensitivity (especially with people who keep saying "Are you still around?")[image] Impatience and restlessness Impatience and restlessness[image] Dreaming and fantasizing about the baby Dreaming and fantasizing about the baby What You Can Expect at This Month's Checkup You'll be spending more time than ever at your practitioner's office this month (stock up on some good waiting-room reading if you've already plowed through the office collection), with appointments scheduled weekly. These visits will be more interesting-the practitioner will estimate baby's size and may even venture a prediction about how close you are to delivery-with the excitement growing as you approach the big day. In general, you can expect your practitioner to check the following, though there may be variations, depending on your particular needs and your practitioner's style of practice: [image] Your weight (gain generally slows down or stops) Your weight (gain generally slows down or stops)[image] Your blood pressure (it may be slightly higher than it was at midpregnancy) Your blood pressure (it may be slightly higher than it was at midpregnancy)[image] Your urine, for sugar and protein Your urine, for sugar and protein[image] Your feet and hands for swelling, and legs for varicose veins Your feet and hands for swelling, and legs for varicose veins[image] Your cervix (the neck of your uterus), by internal examination, to see if effacement (thinning) and dilation (opening) have begun Your cervix (the neck of your uterus), by internal examination, to see if effacement (thinning) and dilation (opening) have begun[image] The height of the fundus The height of the fundus[image] The fetal heartbeat The fetal heartbeat[image] Fetal size (you may get a rough weight estimate), presentation (head or buttocks first), position (front or rear facing), and descent (is presenting part engaged?) by palpation (feeling with the hands) Fetal size (you may get a rough weight estimate), presentation (head or buttocks first), position (front or rear facing), and descent (is presenting part engaged?) by palpation (feeling with the hands)[image] Questions and concerns you want to discuss, particularly those related to labor and delivery-have a list ready. Include frequency and duration of Braxton Hicks contractions, if you've noticed any, and other symptoms you have been experiencing, especially unusual ones. Questions and concerns you want to discuss, particularly those related to labor and delivery-have a list ready. Include frequency and duration of Braxton Hicks contractions, if you've noticed any, and other symptoms you have been experiencing, especially unusual ones.

You can also expect to receive a labor and delivery protocol (when to call if you think you are in labor, when to plan on heading to the hospital or birthing center) from your practitioner; if you don't, be sure to ask for these instructions.

What You May Be Wondering About Urinary Frequency-Again "During the last few days, it seems like I'm in the bathroom constantly. Is it normal to be urinating this frequently now?"

Having a little first-trimester deja vu? That's because your uterus is right back where it started: down low in your pelvis, pressing squarely on your bladder. And this time, the weight of your uterus is significantly greater, which means the pressure on your bladder is greater, too-as is that need to pee. So you go, girl-again, and again, and again. As long as frequency isn't accompanied by signs of infection (see page 498 page 498), it's completely normal. Don't be tempted to cut back on fluids in an attempt to cut back on your trips to the bathroom-your body needs those fluids more than ever. And, as always, go as soon as you feel the urge (and can find a bathroom).

Leaky Breasts "A friend of mine says she had milk leaking from her breasts in the ninth month; I don't. Does this mean I won't have any milk?"

Milk isn't made until baby's ready to drink it-and that's not until three to four days after delivery. What your friend was leaking was colostrum, a thin, yellowish fluid that is the precursor to mature breast milk. Colostrum is chock-full of antibodies to protect a newborn baby and has more protein and less fat and milk sugar (the better to digest it) than the breast milk that arrives later.

Some, but far from all, women leak this phenomenal fluid toward the end of their pregnancies. But even women who don't experience leakage of colostrum are still producing it. Not leaking, but still curious? Squeezing your areola may allow you to express a few drops (but don't squeeze with a vengeance-that'll only result in sore nipples). Still can't get any? Don't worry. Your baby will be able to net what he or she needs when the time comes (if you plan to breastfeed). Not leaking isn't a sign that your supply won't ultimately keep up with demand.

If you are leaking colostrum, it's probably just a few drops. But if you're leaking more than that, you may want to consider wearing nursing pads in your bra to protect your clothes (and to prevent potentially embarrassing moments). And you might as well get used to the wet T-shirt look, since this is just a glimpse of leaky breasts-and wet bras, nightgowns, and shirts-to come.

Spotting Now "Right after my husband and I made love this morning, I began to spot a little. Does this mean that labor is beginning?"

Don't order the birth announcements yet. Pinkish-stained or red-streaked mucus appearing soon after intercourse or a vaginal examination, or brownish-tinged mucus or brownish spotting appearing within 48 hours after the same, is usually just a normal result of the sensitive cervix being bruised or manipulated, not a sign that labor's about to start up. But pinkish- or brownish-tinged or bloody mucus accompanied by contractions or other signs of oncoming labor, whether it follows intercourse or not, could be signaling the start of labor (see page 359 page 359).

If you notice bright red bleeding or persistent red spotting after intercourse-or any time, for that matter-check in with your practitioner.

Water Breaking in Public "I'm really worried that my water will break in public."

Most women worry about springing an amniotic leak-especially a public one-late in pregnancy, but few ever do. Contrary to popular pregnancy belief, your "water" (more accurately, your membranes) isn't likely to "break" (more accurately, rupture) before labor begins. In fact, more than 85 percent of women enter the birthing room with their membranes fully intact. And even if you end up being among the 15 percent who do spring a prelabor leak, you won't have to fear a public puddle at your feet. Unless you're lying down (something you probably don't do much in public anyway), amniotic fluid is less likely to go with the flow, and more likely to come out as a slow trickle-or at most a small gush. That's because when you're upright (standing, walking, even sitting), your baby's head acts like a cork in a bottle, blocking the opening of the uterus and keeping most of the amniotic fluid in. In other words, it's probable that the forecast for the rest of your pregnant future will remain "mainly dry."