And for once, it is ok to become a little more zombified, a little more forgetful, and a little more weaker as science has proven that mother's brain shrinks 5% when making a baby...

What sheer sacrifice to all the mothers out there. Be proud ~

Thank you Goop

POSTNATAL DEPLETION

Consider this: If you’ve had a child within the last decade, you might still be suffering some consequences—lethargy, memory disturbances, and poor energy levels, among other symptoms. And according to Dr. Oscar Serrallach, a family practitioner in rural Australia, it’s not just because being a parent is hard—physically, the process of growing a baby exacts a significant toll. The placenta passes nearly 7 grams of fat a day to the growing baby at the end of the pregnancy term, while also tapping into the mom’s “iron, zinc, Vitamin B12, Vitamin B9, iodine, and selenium stores—along with omega 3 fats like DHA and specific amino acids from proteins.” On average, a mom’s brain shrinks 5% in the prenatal period, as it supports the growth of the baby (much of the brain is fat) and is re-engineered for parenthood. He has spent the majority of his career witnessing this syndrome, which he calls Postnatal Depletion, first-hand, watching as women fail—hormonally, nutritionally, and emotionally—to get back on their feet after the baby comes. Dr. Serrallach first became tuned in to it when he encountered a patient named Susan, a mother of five children, who was so emaciated and depleted that she “was visibly running on empty.” After an extensive visit where he ran bloodwork, and proposed nutritional and emotional counseling, she looked at the clock and bolted. And he didn’t see her again: Until she turned up in the emergency room with pneumonia so evolved that she needed intravenous antibiotics. She spent less than a day, before checking herself out against his orders. That image stuck with him—of a woman ripping out an IV to rush back to her family—and its representation of a mother sublimating all of her own needs to serve her children. Part of the brain shrinkage mentioned above, Dr. Serrallach explains, is reprogramming: “It supports the creation of ‘baby radar,’ where mothers become intuitively aware of their child’s needs, if they are cold or hungry, or if they cry at night.” This hyper-vigilance becomes dangerous for the mother when she, in turn, is not supported. When his own wife had their third child he observed that she too was totally destroyed, and unable to get back to “feeling like herself.” Sound familiar? All the moms at goop think we have it. “There is plenty of prenatal support,” he explains, “but as soon as a baby is born, the whole focus goes to the baby. There’s very little focus on the mother. The mother disappears into the shadows of her role.” As in all things, knowledge is power: Below, Dr. Serrallach outlines exactly what you need to do to shake the brain fog, regain your energy, and get back on your feet.

Q

Can you take us through what happens to a mom physiologically and emotionally as the baby grows?

A

What is happening in our society is that many mothers-to-be are already depleted leading up to the conception and pregnancy time. Nature’s design is that the developing fetus will take all that it requires from its mother. The go between to ensure that this happens safely is the placenta. The placenta is unique in humans in terms of how extensively the finger like projections of the placenta reach into the womb lining, thus creating a massive surface area. The reason for this lies in the fetal brain and its huge requirement for energy and fat (in the form of specific fatty acids such as DHA). Toward the end of the pregnancy, up to 7 grams of fat pass across the placenta each day to feed and build the baby (much higher than any other animal). Also, 60% of the total energy that goes to the baby via the placenta is to feed the brain (other primates, including gorillas, have a figure of around 20%).

The placenta serves two masters: the growing baby AND the mother. During the pregnancy, the mother supplies everything that the growing baby needs, hence why so many mothers become low in iron, zinc, Vitamin B12, Vitamin B9, iodine, and selenium. They also have much lower reserves in important omega 3 fats like DHA and specific amino acids from proteins. The placenta also tunes the mother to the baby, and the baby to the mother. This is no accident. The placenta develops at the same time as the fetal hypothalamus (a hormone producing gland in the baby’s brain) and the hormones produced by the placenta look very similar to the hypothalamic hormones—again no accident. A beautiful example of this occurs during birth. What causes labor pains (contractions of the uterus) is oxytocin, which is also known as the “love hormone.” As the baby is squeezed through the birth canal, its hypothalamus produces oxytocin which ends up in the mother’s blood stream, causing more contractions. It is as if the baby is assisting the mother in its own birth. Once the baby is born, there are huge amounts of oxytocin in both the mother and the baby, literally creating this love fest they call the “baby bubble.” This needs to be encouraged and respected, and caregivers and fathers need to be aware of the importance of this time post-birth, when the bond between mother and baby is established. Breastfeeding then keeps this bond strong. This is nature’s design, so the further we drift away from this in terms of interventions such as caesarian surgery, and opting not to breastfeed, the more we can expect the “cascade-like” flow on of “compromises” in the postpartum period and beyond, for mother and baby.

Part of the job of the placenta is to reprogram the mother. It’s as though she gets a “software upgrade,” with some parts of the brain being reinforced and other parts of the brain being lessened. The average brain shrinkage during pregnancy is about 5%, but it is not so much the brain getting smaller, but rather being modified to acquire the skills to become a mother. This is not discussed or respected enough in our society, and I feel mothers need much support and acknowledgement for this new phase of life. Part of this upgrade is the acquisition of the “baby radar,” where mothers become intuitively aware of their child’s needs, if they are cold or hungry, or if they cry at night. This hyper vigilance is obviously vital for the survival of the child but if living in an unsupportive society, it can lead to sleep problems, self doubt, insecurity, and feelings of unworthiness. An extreme example of how this can work to the mother’s detriment is the mother who “discharged” herself from hospital with pneumonia because she needed to get back to her children—without any external support, her upgraded program told her to take care of her children even if it means sacrificing her own health.

Q

You’ve identified a syndrome in mothers, which you call Postnatal Depletion—what is it exactly?

A

It is the common phenomenon of fatigue and exhaustion combined with a feeling of “baby brain.” Baby Brain is a term that encompasses the symptoms of poor concentration, poor memory, and emotional lability. Emotional lability is where one’s emotions change up and down much more easily than they would have in the past, e.g. “crying for no reason.” There is often a feeling of isolation, vulnerability, and of not feeling “good enough.” It is experienced by many mothers, and is an understandable and at times predictable outcome associated with the extremely demanding task of being a mother from the perspective of both childbearing and child raising.

Along with these features, I have identified a typical associated biochemical “fingerprint” that is partly the cause of and partly the result of postnatal depletion.

Q

How many women do you believe it affects? And for how long?

A

I suspect up to 50% of mothers will have some degree of postnatal depletion—possibly more, but because of the focus of our clinic I would have a slanted view. I don’t tend to have mothers seeking my helping who are feeling “amazing.”

Postnatal depletion, I feel, can affect mothers from birth until the time the child is 7 years of age (possibly longer). There is a lot of overlap between postnatal depletion and depression in terms of symptoms and biochemical findings. For some women postnatal depression occurs at the severe end of the spectrum of postnatal depletion.

In Australia, the peak incidence of postnatal depression is four years after the child is born, not in the first 6 months which was previously thought to be the time of highest incidence of depression. This shows that postnatal depression is an accumulation of factors from the pregnancy, delivery, and post childbirth. This is also the case for postnatal depletion though many mothers with depletion don’t experience depression and it is possible to have postnatal depression without the depletion.

Q

What are its symptoms?

A

• Fatigue and exhaustion.
• Tired on waking.
• Falling asleep unintentionally.
• Hyper-vigilance (a feeling that the “radar” is constantly on), which is often associated with anxiety or a sense of unease. I often hear the words “tired and wired” describing how mothers feel.
• Sense of guilt and shame around the role of being a mother and loss of self esteem. This is often associated with a sense of isolation and apprehension and sometimes even fear about socializing or leaving the house.
• Frustration, overwhelm, and a sense of not coping. I often hear mothers say: “There is no time for me.”
• As mentioned, brain fog or “baby brain.”
• Loss of libido.

Q

What are its causes?

A

It is multifactorial.

1. We live in a society of continual ongoing stress and we literally don’t know how to relax or switch off. This has profound effects on hormones, immune function, brain structure, and gut health.
2. Woman are having babies later in life. In Australia the average age for a mother having her first baby is 30.9 years.
3. Women tend to be in a depleted state going into motherhood with careers, demanding social schedules, and the chronic sleep deprivation as the norm in our society.
4. As a society we tend not to allow mothers to fully recover after childbirth before getting pregnant again. It is not uncommon to see the phenomenon of “Irish twins” where a mother will have give birth to two children from separate pregnancies in the same calendar year. Also with assisted reproduction we are seeing higher rates of twins which will obviously exacerbate any depletion.
5. Sleep deprivation of having a newborn with some research suggesting that in the first year the average sleep debt is 700 hours! Reduced family and societal support is very common.
6. Our food is becoming increasingly nutrient poor. We are in many cases having “2 mouthfuls of food for 1 mouthful of nutrition.”
7. Though poorly studied, there are specific aspects of the 21st-century lifestyle that are contributory to postnatal depletion. This includes environmental pollutants such as air pollution, heavy metals, chlorinated water, and “electrosmog” to name a few.
8. There is a perceived notion that the mother has to be “everything” and as result many mothers suffer in silence and are not receiving education, information, or support. Multi-generational support groups for mothers have been part of indigenous cultures for millennium though they are sadly absent in our post-industrial culture.
9. The phenomenon of inter-generational epigenetic changes in the expression of our genetics is very complex but explains in part the higher rate of allergic disease and autoimmune disease that we are seeing in our society. In short we cannot do the same as what our parents or grandparents did and expect the same level of health. We literally have to “up our game” just to experience the same level of health as our parents, let alone experience better health.

Q

Where should women start in terms of starting to feel like themselves again?

A

In our clinic we talk about the four pillars of health: Sleep, Purpose, Activity, and Nutrition. I use the acronym SPAN to illustrate this, alluding to the fact that while our lifespan is getting longer, our health span (the years of independence and health) in society is getting shorter. We address all four pillars with the repletion, recovery, and realization parts of our program. As a mother graduates from each level we look at each pillar in more depth knowing we can gain traction with the work that has been done at the previous levels. Giving too much information can be overwhelming and unnecessary but to regain and maintain vitality it is important to continue the journey of improvement. Trying to give a mother information about specific food additives, plastics to avoid, pesticides to be aware of, cleaning products and cosmetics that may be contributing to fatigue and hormonal issues may be total overwhelm for a mother in the repletion phase of her program when she has fatigue and a foggy brain. But this same information is most necessary in the recovery phase to enable continued ongoing health and wellness not only for herself but for her family and community.

We use a 3-step program as a guide to help mothers.

REPLETION and REBUILDING of micronutrients and macronutrients

1. Go see a good functional health practitioner and get a comprehensive assessment of micronutrients, -vitamins, and minerals: We often find iron, Vitamin B12, zinc, Vitamin C, Vitamin D, Magnesium, and copper are deficient, insufficient, or out of balance.

2. I universally will start mothers on DHA (an omega 3 fatty acid), which is vital in repairing the nervous system and brain. This can be found in a number of supplements and is typically sourced from fish or algae.

3. A nutritional assessment to identify food sensitivities and food intolerances as these are often created or worsened in the pregnancy.

4. Nutritional advice often will begin by getting mothers off the “cardboard-hydrates,” i.e. hollow carbohydrates and focus on nutrient dense foods.

5. Get support, get support, get support. You can’t have too much support and a babysitter is a lot cheaper than a divorce.

6. Physical therapies that help engage the relaxation response can be very useful in this first part of the repletion program. I particularly recommend restorative yoga and acupuncture.

7. Having assessments and therapies around hormonal health can be super useful.

8. Seeing a life coach, counselor, or psychologist around supporting emotional well being is important.

9. We have specific recommendations around improving overall energy, sleep quality, and physical activity which are all equally important parts of the road to recovery.

10. Hormonal health is obviously very important. What I find fascinating is that often after addressing specific nutrient deficiencies and insufficiencies and giving support around sleep diet and lifestyle hormonal health usually improves. In assessing hormones I find using questionnaires and salivary hormone tests to be most useful. The most comprehensive test is a urinary steroid hormone screen but it is costly, requires more time to interpret, and takes longer to get the results. Blood tests for hormones are not that useful due to day/night variation in levels and due to binding globulins in the blood which can give a misleading result. The “free” unbound hormone as found in saliva is actually what the body utilizes. Given that, the blood tests for hormones that may have some use are thyroid, DHEAs, and testosterone. In terms of therapies initially it is important to look at lifestyle issues around physical activity, sleep, and stress management. In fact the most important thing I believe is the “relaxation response” and to ensure that people can indeed relax properly. It sounds strange to say but many of us don’t know how to relax properly, that when we are “relaxing” we are in fact stressed. Restorative yoga, acupuncture, sound healing, and biofeedback such as HeartMath can all be useful activities to help teach us to relax properly!

11. After assessing and addressing lifestyle issues then the next aspect of hormonal health is individualized herbs and supplements such as Rhodiola, Hypericum, Ashwaganda, and Phosphyltidyl Serine. A big issue around herbs is quality—I’ve found that only good quality herbs work so I have become somewhat fussy about my brands! Occasionally direct hormonal supplementation is required especially in the case of thyroid dysfunction.

RECOVERY is the 2nd step in our program and looks at the important areas of

• Optimizing sleep
• Optimizing activity and exercise
• Education around the healthy home and the healthy kitchen
• Recovering and optimizing relationships

The recovery part of the program we take the same principles of Sleep, Purpose, Activity, and Nutrition but take them to a more in-depth level especially as mothers are starting to feel better, think more clearly, and take on more in terms of the house, kitchen, and “self time.”

Education around the healthy home and the healthy kitchen usually begins with resources like Healthy Home, Healthy Family by Nicole Bijlsma and the Environmental Working Group.

The best type of exercise is activity, and if it is fun and social, mothers are much more likely to make this a habit.

Follow-up with a psychologist, life coach, or mentor: I think this is essential during the recovery phase to help re-evaluate a mother’s direction and purpose in life and to look at how to get a healthy balance between family life and personal self growth and support. This is very much encouraged and we are bringing more and more of this level of therapy within the clinic. This can also shed light and insight onto relationships with partners, families, and friends which may already be strained and neglected or at times broken leading to even less support in a mother’s world. The primary relationship between mother and other parent (if present) whether it is the father, stepfather or second mother often needs some special attention especially after the battering of the storm of early childhood. There are psychologists and therapists that specialize in this type of “relationship rebuilding.”

Fatigue is the most common symptom in postnatal depletion. Having vitality or boundless energy is the end result of a series of body systems being in sync. Having deep chronic fatigue is the end result of these systems being out of sync. I find a combination of addressing micronutrient deficiencies along with macronutrient imbalances is a good start. The most important initial micronutrients include iron and Vitamin B12, zinc, Vitamin C, and Vitamin D. With macronutrients increasing healthy fats and focusing on quality protein such as organic eggs, fish, and meats and also knowing which are the healthier carbohydrates. The best quality carbohydrates tend to come from the “above ground” vegetables such as broccoli and cabbage.

Sleep is a conundrum for many mothers as they are too tired and too stressed and busy to sleep well. Sleep hygiene is an important place to start where what you do in the hour before sleep can make a huge difference. This involves exposing yourself only to soft yellow to orange lighting, a soothing environment with calming music, and as much as children allow, to treat your bedroom as a “temple.” In fact, if there is only one room that you keep tidy in your house if should be the bedroom.

Once the lights are out, the room should be cool and as quiet and dark as possible. Computer use, TV, and emotional stress tend to hijack sleep quality and should be avoided in the hour of wind down to sleep.

Depending on your personal testing there can be a range of natural sleep enhancers that can be very useful including GABA, 5-HTP, Melatonin, and Magneisum salt foot baths.

If “switching off” is the problem then techniques such as HeartMath HRV-based relaxation and brain entrainment with binaural beats are a couple of the techniques that can be used to help “switch off the computer” and allow sleep to happen faster.

3. REALIZATION is step 3 in the program and is about understanding motherhood as part of the heroine’s journey and discovering self-actualization through this process

My intention is to publish a book this year that is partly a workbook to take women through the three stages of our program. There will be a fourth part of the book that explains what postnatal depletion is and how as a society we arrived at this point in history of having exhausted, disconnected mothers. There will be an associated website that will have numerous questionnaires with online scoring and protocol generation to supplement the book. The website will have all the aspects of supports, blogs, and information that you would expect from an intentional online community.

Q

Why is this a new thing? Or is it not a new thing and just newly acknowledged? Have women been experiencing this since the beginning of time?

A

It is certainly much more common these days. Most of the so-called primitive cultures or first people of the world had very specific practices to ensure that mothers made a full recovery from childbirth. This is something that is not much talked about in today’s age. These are called Post-Partum Practices. From China to India, from Aboriginal Australia to the Americas, there have been centuries of very deliberate practices in nutritional recovery, spiritual cleansing, and protection as well as elaborate social supports.

In traditional Chinese culture they observe the sitting month “Zuo Yue Zi” where the mother would not leave the house for 30 days, would not receive any visitors, and would have no duties apart from breastfeeding the baby. Special “rebuilding” warm foods would be supplied and the mother would not be allowed to get cold or even shower in that time.
Ancient cultures have made the realization that Western society unfortunately has not: For society to be well and prosper, the mothers must be fully supported and healthy—in every sense of the word.

—-

Oscar Serrallach graduated from Auckland School of Medicine in New Zealand in 1996 before moving to Australia in 1998. After doing the standard medical rotations he did further work in a number of hospital and community-based jobs including Emergency Medicine, Psychiatry, Aboriginal Men’s Health, and Addiction medicine. In 2003, he moved to Nimbin, NSW and began working in an alternative community which exposed him to nutritional medicine, herbalism, and home birth. He started a family and had three children in Nimbin before moving to Mullumbimby in 2011 to start the Mullumbimby Integrative Medical Centre. There, he focuses on Nutritional and Environmental Medicine with a special interest in helping women recovey from the postnatal period. Until recently, he was a board member for ACNEM (Australasian College of Nutritional and Environmental Medicine) and is currently the college’s journal editor.

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Can you be too Sore to Work out?

aka DOMs

Original post here

Take advantage of your soreness and have it guide you during workouts.

By Tesa Johns

13 April, 2016 at 08:30PM

So you went to the gym and you had your best workout yet. Your intense and satisfying workout left you wanting more. Now you can’t wait to get back into the gym…until you wake up the next day and feel like you got hit by a thousand pound bag of bricks.

Soreness is not always a bad thing and can be used to your advantage. Take the day to get in some light cardio or do a long stretch routine. Your soreness may be the thing you need to take in a relaxing yoga session. Another possibility to defeat soreness is to work on the muscles that aren’t sore. If its your arms and back that are sore, try working your legs and abdominals.

Soreness, or more scientifically known as delayed onset muscle soreness (DOMS), is a side effect of the muscle repair process that develops in response to microscopic muscle damage. Muscle damage is needed for the muscle fibers to repair themselves and gain strength. Imagine fraying a shirt and repairing it with twice the amount of thread. A common misconception is that DOMS is due to lactic acid. Lactic acid is not a component in the muscle soreness cascade. Origins of muscle soreness accompany many symptoms and are complex.

Activities known to cause DOMS include strength training, downhill walking/jogging, aerobics, and plyometric exercise. Plyometric training, or “plyos,” are exercises where muscles exert maximum force in small bouts with the goal of increasing speed and strength. An example of a plyometric would be squat jumps or box jumps.

Often, muscle soreness will only last a few days and may diminish during activity. Light activity can help to diminish symptoms of muscle soreness. Light workouts get your blood flowing at a faster rate than remaining stationary. Blood flow in our body is like a highway helping to move things along. In this case, helping to move out the inflammation caused by your sore muscles and previous workout. Heading back to the gym may be the best option! Unless of course you find it difficult or too painful to perform daily living activities, then it is advisable to refrain from activity and return once the pain subsides.

When you finally get up the gusto to head back to the gym, begin with a light stretching session. For each muscle group you stretch, make sure to stop at the point of pain. Going further than the point of pain may cause negative side effects, such as overstretching the muscle making it susceptible to injury. A light activity that may be beneficial is cardio or bodyweight exercises. Getting the blood flowing and warming your body up should be the goal. If your primary goal is to reduce symptoms, then treatment such as an ice pack application, massage, tender point pressure, or an oral pain reliever may be useful.

Tender point pressure may be accomplished using a foam roller and lightly rolling over the entire muscle. When you reach the point of pain stop rolling but remain applying pressure for 3-5 minutes.

Soreness is your body telling you when damage has occurred. Don't let soreness take away your workout motivation. Use it to accomplish different goals or give yourself a day to treat your body right, but most importantly, do not sit and give up on the day!

Tesa is new to blogging, but hopes to make a big impact with her vast knowledge of athletics and experience. Tesa recently earned her bachelor's degree at the Pennsylvania State University. While majoring in Athletic Training and minoring in psychology, she worked with various division one collegiate sports teams. Tesa is continuing her education by pursuing her Master's of Science in Kinesiology with a concentration in sports pedagogy at The Louisiana State University. Tesa is a board certified Athletic Trainer and a Performance Enhancement Specialist. Outside of the training room, Tesa enjoys going on runs and working out for leisure.

Main Photo Credit: dean sanderson/shutterstock.com; Second Photo Credit: Jacob Lund/shutterstock.com; Third Photo Credit: Sebastian Gauert/shutterstock.com

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8 Signs You’re Ready To Become a Group Fitness Instructor

Ever wonder what it would be like to lead your own class, but aren’t sure you’ve got what it takes to be an effective instructor? I pondered that very question nearly 20 years ago, and I’m so glad I challenged myself to become an instructor, because seeing others reach their fitness goals has filled my soul.

Here are eight signs you’re ready to step up from the front row and step into the role of a certified group fitness instructor.

Given the choice, you would absolutely pick a group workout over hitting the elliptical machine, even if you’re streaming your favorite show! You’re energized by the camaraderie and friendly competition that come with a group. You’re genuinely happy being around other people.

Great instructors lead by example. It takes courage to lead a group fitness class and great leaders know how to bring out the best in others.

To be a great teacher, you need to be a great student, too. The fitness industry is constantly evolving with new research about ways to make physical activity enjoyable. There are endless growth opportunities, from learning to teach different formats to re-thinking class design and music.

You’re a glass half full kind of person. Your Instagram is full of fitness photos and you browse Pinterest for exercise tips and healthy recipes to share with friends and family. You find yourself high-fiving people even for the smallest victories.

You have the ability to laugh at yourself and to adapt to your environment. Teaching keeps you on your toes and requires you to wear many hats, from public speaker and motivator to stand-up comedian. You’ll have 30+ people counting on you for a fun and balanced workout.

Whether you’re a stay-at-home parent, work in an office or have a knack for teaching, leading classes adds some excitement to your day. Early bird, night owl, or weekend warrior? Take a look at any health club schedule and you’ll see classes scattered throughout the entire day, 7 days a week.

Becoming a group fitness instructor requires no prior professional fitness experience, but many personal trainers are able to build a clientele from teaching group fitness classes. If you’re already a personal trainer, teaching group fitness will make you a better trainer. It works the other way around, too!

In just one hour as a group fitness instructor, you have this amazing ability to impact lives for the better. Telling people that they “need” or “should” get physical activity every day isn’t enough. The only way that physical activity can truly start to become a habit is for it to be enjoyable. You can empower others to want to live healthier and to feel good from the inside and out.

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We’ve launched an all new, world-class ACE Group Fitness Instructor Certification study experience. Featuring an interactive, digital learning component that takes you step-by-step through the fundamentals of group fitness—from exercise programming and music selection to engagement and motivation techniques—our study experience will empower you to make every class world-class. Learn more about it right here.

ANDREA WARDINSKY Contributor

Andi Wardinsky, M.S., has been inspiring the world to fitness for over 15 years as a fitness professional and educator based in Seattle, WA. Known for her infectious energy and love of music & movement, Andi holds a master’s degree in physical education, numerous specialty certifications, and is a Master Trainer for the American Council on Exercise. As an ACE Certified Group Fitness Instructor & Personal Trainer combined with her past experience as a general manager and group fitness director, Andi loves to educate fitness professionals on various topics in the industry through local establishments, national conferences, and various publications. 

More Blogs by Andrea Wardinsky »

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How Bad Is That Cough? 7 Bad Coughs to Worry About

As winter draws near, this is something useful for the parents. I'm on a lookout for Whooping Cough coz that is like the major of the major compared to all other coughs...

Isn't it amazing how many tissues and bowls of soup your family can go through in one season? Don't assume, though, that your child's cough is simply a cold it might be something more serious. Here's when to worry and what to do.

By Aimee Herring from Parents Magazine

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When to Worry: Coughs & Colds

The Barking Cough

Tara Donne

Your child went to bed with a stuffy nose but he's been sleeping peacefully for a few hours. Suddenly, you hear what sounds like a barking seal over the baby monitor. You run in and find your child struggling to catch his breath.

What's probably causing it: Croup, a viral illness that causes inflammation in the larynx (voice box) and the trachea (windpipe). It's most common between October and March, and it usually affects children ages 6 months to 3 years. The telltale cough usually gets better during the day but returns for two more nights. He may also make a high-pitched whistling sound (called stridor) when he inhales. Some kids tend to get croup every time they have a cold.

How to help: When your child wakes up barking, bundle him up and go outside -- cold air often helps relax the airways. Or turn on a hot shower and sit with your child in the steamy bathroom for 15 to 20 minutes, since the warm, moist air also may help him breathe, says Parents advisor Jennifer Shu, M.D., editor of The American Academy of Pediatrics' Baby and Child Health. Call 911 if your child is truly having trouble breathing or if he has stridor that gets worse with each breath or lasts for more than five minutes. Between attacks, use a cool-mist humidifier in his room, and make sure he drinks plenty of liquids. Although croup usually resolves on its own, always call your doctor when you suspect it. Recent research has found that one dose of oral steroids -- which doctors used to prescribe only for severe croup -- may also be helpful for milder cases.

• Is my child too sick for school or daycare? Find out now.

The Phlegmy Cough

Your child's cough sounds mucousy, and she also has a runny nose, a sore throat, watery eyes, and a poor appetite.

What's probably causing it: A common cold, which can last for one to two weeks -- although it's at its worst (and most contagious) in the first few days. Children get an average of six to ten colds a year, according to the National Institute of Allergy and Infectious Diseases, so you can expect more than a few this winter.

How to help: Since colds are caused by viruses, antibiotics won't help -- don't even ask your pediatrician to prescribe one. (However, do call your doctor if your child has persistent green snot and a fever, because she may have developed a bacterial sinus infection.) If your child is too young to blow her nose, use saline nose drops and a bulb syringe to help clear the mucus and make her less likely to cough. Using a cool-mist humidifier and giving her a warm bath can also help. You may want to let your child inhale some vapor rub on a towel, but don't put the rub directly on her skin unless your doctor advises it. Also check with your doctor before giving your child any over-the-counter medicines, and ask when she'll be old enough to suck on cough drops.

The Dry, Nighttime Cough

Your child has had an annoying cough off and on all winter long. It gets worse every night and any time he runs around.

What's probably causing it: Asthma, a chronic condition in which the airways in the lungs become inflamed and narrowed, and they produce excess mucus. Although parents often think that wheezing is the primary sign of asthma, a hacking cough -- particularly at night -- may be a child's only symptom. "The mucus in the lungs creates a little tickle, which makes kids cough," explains Debbie Lonzer, M.D., assistant professor of pediatrics at Cleveland Clinic Children's Hospital. Other red flags: The cough is triggered by exercise, allergies, colds, or cold air. If your child is young or thin, you may see his chest caving in as he breathes.

How to help: See your doctor if you suspect asthma. Children who are old enough (usually age 5 or 6) will blow into a special tube to test lung function. To make a diagnosis in younger kids, doctors usually rely on the child's exam along with parents' reports about the pattern of symptoms and any family history of allergies or asthma. Children with mild cases can take inhaled bronchodilator medication during an attack, while kids with moderate-to-severe asthma also need a daily preventive medicine. Call 911 if your child ever has significant trouble breathing or he becomes unable to speak, eat, or drink.

The Miserable Cough

For the first time in her life, your child is too wiped out to play. She's got a weak, hoarse cough, as well as a high fever, muscle aches, and sniffles.

What's probably causing it: Influenza, otherwise known as the flu, a viral illness that attacks the respiratory system. The flu has a long incubation period in kids, so they can walk around with the virus for days before they get sick, sharing it with friends and family. "It's spread through little droplets, so when a classmate sneezes just once, the flu virus flies across the room," says Dr. Lonzer.

How to help: Give her plenty of fluids, as well as either acetaminophen or, in children older than 6 months, ibuprofen with food or milk to bring down her fever and relieve aches. Next year, be sure she gets the flu vaccine.

The Wheezy, Gurgly Cough

Your baby has had a cold for a few days, and now his cough has a raspy, whistling sound. He seems to be breathing rapidly and is very irritable.

What's probably causing it: Bronchiolitis, an infection of the bronchioles, the tiniest airways in the lungs. When they swell and fill with mucus, it's difficult for a child to breathe. The most common cause is the respiratory syncytial virus (known as RSV). Bronchiolitis most often strikes young babies during the winter months, says Allan Lieberthal, M.D., clinical professor of pediatrics at the University of Southern California, in Los Angeles.

How to help: Contact your pediatrician immediately if your child seems to be having difficulty breathing or drinking. According to new guidelines issued by the American Academy of Pediatrics, babies typically don't need a chest X ray or blood tests. Your doctor can diagnose bronchiolitis with a physical exam and a thorough history. Encourage your child to rest and drink plenty of fluids. Most children don't need medication (bronchodilators, antibiotics, or steroids), according to the new guidelines. In serious cases, a child may need to be hospitalized to receive oxygen, fluids, or medication.

The Whoopy Cough

Your child has had a cold for more than a week and now she's having coughing fits -- sometimes she'll cough more than 20 times in one breath. Between coughs, she has trouble breathing and makes a strange whooping sound as she inhales.

What's probably causing it: Whooping cough, which has recently been on the rise. Bacteria called pertussis attack the lining of the breathing passages, producing severe inflammation that narrows -- and sometimes even blocks -- the airways. Children who've not yet been fully immunized are most likely to catch whooping cough (the five-dose DTaP vaccine is usually given at 2, 4, and 6 months, between 15 and 18 months, and between 4 and 6 years). However, young babies are at greatest risk. "Infants under 6 months don't have enough strength in their lungs to make the characteristic whooping noise, so it's harder for parents to detect," says Gordon Bloomberg, M.D., associate professor of pediatrics at Washington University School of Medicine, in St. Louis. Instead, their coughs may come in continuous bursts ending with gagging or vomiting, they may briefly stop breathing, and their lips may turn purple because they're not getting enough oxygen.

How to help: Call your doctor immediately if you suspect whooping cough. Babies under 6 months will need to be hospitalized. The infection is treated with antibiotics, and other adults and children in your household may need preventive antibiotics and a booster shot to avoid getting sick. (Whooping cough is highly contagious, and immunity begins to wane five years after immunization.) Antibiotics will clear up the infection after about five days if they're started early enough, but your child's cough may linger for months and also return when she gets subsequent respiratory infections.

What Does Whooping Cough Sound Like?

The Really Gross Cough

Your child's had a cold for a week now, and it's getting worse. His cough is wet and phlegmy, and his breathing seems to be faster than usual.

What's probably causing it: Pneumonia, in which a virus or bacterium invades the lungs, causing them to fill up with fluid. "Because the child is trying to get the fluid out of his lungs, a pneumonia cough tends to be pretty ugly," says Dr. Lonzer. "This is the hacking-up-goobers one."

How to help: Your pediatrician may be able to diagnose pneumonia with a physical exam but might need to send your child for an X ray. She may do an oxygen-saturation test (placing a bandage-like strip around your child's finger) to check for a low oxygen level. If the doctor determines from the test results that the pneumonia is bacterial, she'll prescribe antibiotics; viral pneumonia has to run its course. Pneumonia can usually be treated at home, but if it's severe, your child may need to stay in the hospital for a few days.

Simple Cough Soothers

• Plenty of water
• Nasal aspirator
• Chicken soup
• Cool-mist humidifier

Originally published in the February 2007 issue of Parents magazine.

All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

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10 Tips for Powering Through Plateaus

There will be some days where you will come across this phase....I tend to hit no.10 when I get stuck here just to 'breathe' step back and refresh.

Thank you ACE

So you’ve been taking full advantage of your gym membership and have actually been going consistently. Great work! If you’re like most people, however, at some point you might start to feel like you’ve hit a plateau, because you’re no longer seeing the results that kept you motivated in the beginning. It happens. Let’s take a closer look at why plateaus occur and what you can do to avoid them.

Stalled results can be caused by a number of factors, but generally it means your body has adapted to whatever physical stimulus you have been giving it. To experience continuous progress, it is essential to keep both your mind and body guessing, while continuing to fuel your body efficiently. Here are 10 tips for pushing past plateaus:

1. Routine is the enemy.

To really change your body, your training has to be consistently intense and varied. If you do the same class every day, your body is going to adapt. You have to keep creating a challenging stimulus so your body can’t get too accustomed to what you’re giving it. Change happens outside your comfort zone.

2. Strength training is essential.

Stop doing hours of cardio and back-to-back indoor cycling classes. Focus on building lean muscle mass so that your body becomes a lean, mean burning machine. Chronic cardio can actually eat up muscle and increase cortisol levels, causing you to store fat.

3. Increase your intensity.

Perhaps you are diligent about switching up your routine, but still aren’t seeing the results you want. Here’s a possible solution: Lift heavier and/or go faster. Instead of doing a million reps at a low weight, try doing more weight for fewer reps. Similarly, instead of doing your standard run, run a 5K or a mile as fast as you can, or try switching it up with sprints instead.

4. Prioritize protein.

To build lean muscle mass, you must fuel your body with protein to create an anabolic foundation. Eat some high-quality protein with every meal, along with healthy portions of veggies.

5. Ditch the processed foods.

Say no to fake food, and yes to nutrient-dense whole foods. If it comes in a package, a bag or a box, steer clear. And don’t forget that real food doesn’t have ingredients—it IS an ingredient.

6. Tailor your intake to meet your nutritional and caloric needs.

Perhaps you have already dialed in your diet, but are still in a fat-loss slump. Take a closer look at all those bites, nibbles, tastes and snacks you may be mindlessly consuming. Raw nuts, avocado and almond butter are great healthy options, but you still need to keep an eye on your portion sizes.

7. Hydrate.

Your body cannot perform optimally if it doesn’t have sufficient water. While coconut water and tea add to your overall fluid intake, don’t forget to drink plenty of plain water as well to make sure you’re meeting the recommended daily intake.

8. Get enough sleep.

Adequate rest is just as important as nutrition and fitness. If your body doesn’t get the sleep it needs, you simply won’t get the results you want.

9. Don’t overdo it.

Sometimes plateaus show up when we are overtraining. Take a look at your fitness schedule. Are you sore all the time? Do you allow your body to recover by implementing full rest days? Remember, rest days are essential to allow your body to build the lean muscle mass you are working so hard to achieve.

10. Have fun.

The best exercise is the one you are actually going to do. The most important part about any fitness regimen is consistency. Find something you actually enjoy doing and then give it everything you have. Ideally, it becomes a positive outlet that empowers you to be better, both in and out of the gym.

KELLEY VARGOContributor

Kelley Vargo, MPH, MS, CSCS, ACE Health Coach is a recent graduate of the Milken Institute School of Public Health at The George Washington University where she received her MS in Exercise Science with a concentration in Strength & Conditioning and her MPH in Communication & Marketing. Ms. Vargo has contributed content to Discovery Health as well as the ACE Fitness Journal. She is a member of the International Society of Sports Nutrition, Delta Omega Public Health Honors Society, and a Metabolic Effect Instructor. She enjoys sharing her passion and energy with others, helping them create healthier and happier lives. Follow Kelley on twitter @kelleyvargo or contact her at kmvfitness@gmail.com or www.kelleyvargo.com.

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