​What is the Fourth Trimester? We all talk about the different stages of pregnancy in “trimester” terms. Generally the first 12 weeks after your baby is born is referred to as the Fourth Trimester. There is no real timeline in this time period. No “your baby is the size of a fruit” to look forward to. Everything is focused on your new baby and their development, smiles, coos, crawling—-but what about mom? Many times we get a little lost in the shuffle. This season of life is so busy, we lose sight of our own health and wellness. Between lack of sleep, returning to work, finding daycare, traveling to see family, feeding, snuggling, and changing diapers, there are not enough hours in the day!

Generally when you deliver the baby, you see your OBGYN/Midwife at the 6 week postpartum appointment, then possibly no further visits for a very long time. There are many studies that have been done regarding careful follow up for moms that are in this postpartum period and beyond. It is so important to have an established relationship with your primary care provider during this time period for many reasons. Whether it is late-onset postpartum depression/anxiety, tension headaches, sore throats, anemia, thyroid changes, constipation, weight gain or loss, your PCP can help! 

Many of my patients have come in either for themselves or their baby’s well child visits, and we discover that there is a problem that needs worked on. It is great to be able to ask “is it normal?” questions to someone that you trust—and get some real and helpful answers. It is great to be able to ask if it is ok to take ______ supplement of medication when you are breastfeeding. It is wonderful to be able to get a referral to physical therapy when you need it. Not losing weight like you want to? We can help with safe weight loss and guidance on nutrition and exercise during this time period.

There are so many reasons to have an established relationship with your primary care provider. At IFM, we love caring for whole families: mom, dad, babies, siblings, and beyond! When we get to know you and your family, understanding the dynamic helps us be able to “customize” your care. We do not like putting people on algorithms or in boxes! We do things differently here and are so happy to include you and your family in our care!

Our recent addition of lactation services, provides yet another way for IFM to reach the needs of postpartum mothers in that fourth trimester. Check out our website for more information on group lactation classes or private consultations with Crystel Corbin, RN, IBCLC. 

The season of giving is here. Many of us are wondering what to give our kids. Or if you are like me, what are we going to give them that they will actually play with and possibly learn something from? Well I have compiled a list of what I believe are the top 10 developmental toys perfect for infants and toddlers. ​

1. High Contrast Toys, Books, & Cards. These are the perfect gift for our newest members of the family, specifically infants 0-3 months old. High contrast toys and books are beneficial because these images are visually stimulating and can help the baby’s retina send signals to the brain making their brain development stronger. 
2. Sensory Balls: These may seem simple but they actually do a lot for development and are a favorite for infants and toddlers. Sensory balls can encourage your child’s fine and gross motor skills, hand-eye coordination, visual tracking, and are great tactile stimulation. 
3. Rattles:  Rattles grab a baby’s attention for many reasons. They can help with auditory stimulation, encourage grasping skills, promote gross motor development, foster hand-eye coordination, and even promote independent play.
4. Cause and Effect Toys: Learning cause and effect is an important part of child development. Cause and effect toys can encourage learning and social development. Some examples of cause and effect toys are: pop up toys, pound a ball, car ramp track, music toys (drums, keyboards, shaker eggs, etc), and pull back cars. 
5. Blocks: Stacking toys encourage the development of fine motor skills, and encourage concepts like math and problem solving. Bonus these are popular with babies and toddlers, so a great longevity toy as well! 
6. Shape Sorter: Besides the obvious of teaching your child shapes and colors. Shape sorters also strengthen their hand-eye coordination, fine motor skills, and are great for language development as well. 
7. Puzzles: Puzzles are a great way to encourage cognitive development such as problem solving, as well as hand-eye coordination, and building focus and patience. Use phrases such as “turn it,” “flip it,” and “slide it,” to encourage language development and aid them in solving the puzzle.
8. Figurines: Figurines are great for imaginative play, emotional development, and language development. Try using figurines to teach social skills by role playing with your toddler. For example, “Ouch! The Dinosaur bit me. Be gentle dinosaur when you play with your friends, we don’t bite.” 
9. Riding Toys: Ride on toys have many benefits such as: promotes gross motor skills, foster’s independence, builds confidence, and sparks creativity and imagination.
10. Imaginative Play Toys: Toys that encourage imaginative play such as toy food, dress up clothes, and dolls, have many benefits. When we promote imaginative play, we encourage the development of social and emotional skills, language development, and problem solving skills. 

This list covers most bases when it comes to toys, but I would like to add that books make great gifts and encourage language development. Also my favorite gifts to give are experiences, for me creating long lasting memories with my loved ones is what the holidays are all about. So experiences that I can join them on are always my go to gift. Whatever you celebrate, and whatever you choose to give, I hope you have a very happy holiday season! 

Please stay posted, as Sensory Classes will resume next month.

Stephanie, Pediatric Sensory Specialist 

​The amount of information out in the world today about health and wellness can be overwhelming for many of us. It’s tough to know who to trust with so many contradictory reports and opinions. We hear conflicting messages about what matters most for optimal health. Check any social media platform, we find many eager to sell the latest recipe, formula or action plan for success, happiness and health. However, amongst the noise, there are incredible people doing incredible work every single day to connect and share with the world all the most effective ways to live in alignment with one’s best self.

One of those incredible people is world renowned brain researcher at Harvard Medical School, Dr. Rudolph Tanzi. I’ll spare you the entire list of his many accomplishments (you can use google), however a few of his accolades include: Co-director for the Center for Brain Health at Massachusetts General Hospital, author of over 500 Research studies, one of Time Magazine’s 100 Most Influential People in the World, and the person credited with discovering the first Alzheimer’s Gene. He’s also the staff Neuroscientist for the New England Patriots. This man is not your Tik Tok spiritual guru. The guy is world class.

I was recently listening to a wonderful lecture by Dr. Tanzi, and I’d like to share some takeaways from his presentation. A primary message of the talk was this: Reducing inflammation in the brain and body allows and promotes optimal health. Dr. Tanzi puts it bluntly, “Inflammation is the main killer.” More and more of us experience brain fog, memory impairment, decreased focus and feelings of being less mentally sharp every day. Many of these “symptoms”- dare I say signals- our bodies experience point directly to the complex world of inflammation. Pure and simple, inflammation is bad for our brains, yet many of us take little action to treat our brains with the LOVE and care they deserve.

Luckily for us, Dr. Tanzi has powerful suggestions (with plenty of scientific evidence) for anyone, at any age, to take action now to reduce inflammation in the brain and body. The complexity of the inflammatory process is far beyond the scope of this blog, but let’s just surrender to the idea that negative stress within our internal and external environments equals inflammation in humans. Prolonged inflammation equals all kinds of negative health effects on virtually every system of the body. If we can assume this to be true, we want to create a life that aligns with a state of low levels of systemic inflammation. 

Many behaviors promote decreased levels of inflammation, but to continue borrowing from Dr. Tanzi’s work, he has come up with an acronym to help us remember the most powerful ways we can reduce inflammation in the brain, prevent disease, promote mental agility and become as mentally fit as possible. Think S.H.I.E.L.D when you start thinking about brain health. Sleep, Handle Stress, Interaction, Exercise, Learning New Things, Diet.

• Sleep- Vital process of washing out protein debris, free radicals, and other harmful pro-inflammatory byproducts in the brain. Think of each REM cycle as a necessary rinse for our brains. 7-8 hours a night is essential. 
• Handle Stress- Think meditation, mindfulness, self-awareness, breath work, mindset. The healing power of meditation is showing remarkable changes in the brain, down to a genetic level. If you aren’t doing some form of meditation (there are so many to choose from), you are missing out on a transformational practice. 
• Interaction- Loneliness is a risk factor for poor health that appears to be rising rapidly in our technologically obsessed, socially disconnected world. People are important. Connect with your fellow humans.
• Exercise- Movement is all about blood flow. Exercise helps reduce inflammation in many wonderful ways. Not only that, but it delivers all kinds of good nutrients, chemicals and hormones made in the body up to the brain.
• Learning New Things- help build resilience and synaptic connections (we lose these as we age). It’s important to build up a reserve, which strengthens the neural network. Learning something new makes new synapses (connections between brain cells) every time. Read a nonfiction book, try new hobbies, watch a documentary, try things that directly challenge your brain- neurobics- aerobics, but for your neurons. 
• Diet- Care to guess the #1 diet on the planet for brain health? It’s the Mediterranean Diet. Heavy on fruits, vegetables, nuts, seeds, and whole grains. There is also less or no red meat. Have we all heard of the Gut-Brain connection by now? This diet promotes a healthy gut microbiome. Your gut sends trillions of metabolites to your brain every day. What you put in your mouth is absolutely essential for brain health. You can keep pretending that what you eat doesn’t matter, but the evidence is clear. You can start feeling better with simple nutrition shifts.I’ll give you a couple more quotes from Dr. Tanzi which point to the importance of diet on brain health. 

“The healthier your gut microbiome is, the healthier your brain is. That’s not woo-woo science anymore. There is hardcore evidence.”

“Plant-based fiber is the best thing you can do for your gut and that’s the best thing you can do for your brain.”

Powerful statements. I urge you to read them again, write them down and take action to support your brain and body in a more loving and authentically aligned way. In a world constantly trying to sell you the latest and greatest health product, can you find the wisdom in the simplicity of Dr. Tanzi’s S.H.I.E.L.D approach. Give it a shot. What’s one small step you can take today to inject fresh energy into each category/letter?

If you’re needing help getting your health on track, check out our website to schedule an appointment with an available family practice or mental health provider. https://www.integrativemediowa.com

Dr Justin Janss, DNP, ARNP, PMHNP-BC​