hello and happy Sunday this week we are talking all about pacifiers as well as
ectopic pregnancies for our weekly sit down Sunday q a where we answer your questions yep
and just in case it's your first time meeting us I'm Kirk I'm a board of certified pediatrician
and Dad I'm Sarah I'm a board certified OB GYN and Mama and we are the doctors bjorkman
so starting out this week a question from Kimberly Terry she says hi I'm wondering if
you think pacifiers are a sleep crutch that would prevent sleep teaching from being successful my
six-month-old loves her pacifier and she needs it to fall asleep she cries if I lay her down to
sleep without it so your journey is definitely not the one that is right is a shared Journey
among many parents and we had a little one who used her pacifier to fall asleep didn't really
love it any other time but like there were many many times where they're rocking her to sleep
with the pacifier in her mouth and then just as she was about to fall asleep in her crib
we're twisting that little passport out of the crib and just be like can I sneak it out of her
mouth because if she fell out of her mouth and she woke up and didn't have it problem yep and
so the question is you're trying to help your baby learn how to sleep and sustain sleep with
this sleep learning process that we actually did a whole episode about but you're finding
that if the pacifier isn't in the mouth to begin with maybe it falls out during sleep
that they wake up and so the the time when this can become a potential crutch for them
is if it means that you're coming back into the room to replace the pacifier because then they
like anytime The Pacifier comes out they're rewarded by seeing Mom Dad parent coming in
to help them so a couple ways around this so one you could what we did is we actually like when we
said hey we're new sleep learning we just kind of went cold turkey on the pacifier our little
girl didn't love it that way anyway and so that was just something that we just worked through
um the other piece though is like you could teach them to put the pacifier back in their
mouth on their own this can be a fun game during the daytime by the time they're six months old
they should be able to reach out and grab those and put it in their mouth on their own and if
that's not a skill to have it you can work on that praise them as they do it and then the question
is like how are they going to find one little pacifier in their crib in the middle of the night
um sometimes this can be helped by just sprinkling five seven ten extra pacifiers in the crib so that
when their pacifier falls out they just reach out their cute little hands and grab whatever pacifier
is closest because they've worn during the day they can put it back in their mouth on their own
so there's that self-soothing that you are trying to help them learn so that is kind of a workaround
if you want to if you're not quite ready to to pull the pass by completely that is a way around
it helping your baby learn that and they're learning to be autonomous too the one kind of
piece of interesting medical information with this too is the risk of sudden infant death syndrome or
sudden unexplained infant death is actually lower in children who use pacifiers there's not really
great understanding why this is thought that maybe it helps them kind of protect the front of their
face a little bit from having something cover their mouth or it helps them coordinate their
breathing throughout sleep maybe also too so if you're a pacifier user you definitely don't have
to feel bad or guilty of that your child uses a pacifier in those first couple months of life it
actually is associated with lower risk of some infant death yeah all right good luck our next
question comes from Annette she says I had an ectopic in February that ended in surgery and
removal of my right tube after four months had an hsg performed on my left tube that showed blockage
near the uterus since then I have started IVF and will soon have my transfer but was wondering if
getting my tube unblocked in the future would be something to consider thoughts could another
ectopic happen also your IVF videos have helped me tremendously through this IVF process that's
awesome well thanks I'm glad it was helpful it's such a can be a lonely Journey so sorry
about your ectopic just you've had quite a road here working on building your family and it I'm
sorry for your struggles and grief and sending you all the baby dust and luck for your transfer so
your tube left one is gone generally speaking when we think about ectopics the risk is about
one to two percent um and so what is the next topic that's uh it's when the pregnancy implants
somewhere other than in the uterus most commonly in the fallopian tube but can be other places on
an ovary other places in the abdomen super rare but possible most commonly is the tube
there are different ways to treat an ectopic medication surgery Etc um the thing if when you
remove an ectopic when you take the tube you know that hey the ectopic is gone and you don't have
to worry about getting another one in that tube because it's gone because yes there is a risk the
thought is kind of if you have an ectopic in in a tube is there some dysfunction with that tube to
begin with and then if you do medication or where they just try to take the pregnancy out of the
tube is there Scar Tissue left there or something that is going to lead to another ectopic so
at as you said kind of at the four month Market sounds like they wanted to do an hsg so that's for
people that don't know a hysterocell pingogram or kind of tubal dye test where we inject some
contrast through your cervix up into your uterus while we're kind of taking X-ray pictures to see
if that contrast spills out your tube so Studies have shown that after an ectopic pregnancy if you
lose a tube you still in theory have another good tube that can go back and forth and
Etc you know to grab to to grab an egg from the other ovary not just the side you ovulate on so
losing a tube for an ectopic pregnancy does not reduce and greatly reduce your pregnancy rate
by any means that being said if they looked and said oh hey tube is blocked obviously for to make
a baby egg needs to be able to meet sperm and if sperm can't get there through that remaining too
you're going to have a hard time so in terms of when we thinking about do we unblock tubes
or is that something to explore when I hear that a patient has you know a blockage very
close to the uterus or a proximal blockage that can be one of two things one it's truly blocked
or two there was a spasm of the fallopian tube when the dye was injected and so it's not really
um blocked but it was just clamped down at the time that we you tried to inject the dye through
it all that to say if you end up needing IVF or doing IVF we are bypassing your tubes 100
and so unless in terms of recommendations for my patients if you if your tubes are blocked but we
do not see a dilated tube um meaning that they're you know an ultrasound or on hsg we see that that
tube is dilated with fluid in it or different things like that we don't tend to worry about
it doesn't matter if it's open or not because we are going to put that little embryo right in the
perfect spot in your uterus even with IVF there still is a possibility of ectopic pregnancy again
one-ish percent of the time that's little embryo can migrate off to the tube but very very rare so
again sending you baby dust and hoping for your the rainbow and we've shown some pictures and
actually demonstrations of hsts before too and so that's something you knowing for more information
about you can check out this video that we've got a card here for too thank you so much as always
for your questions we really enjoy this new sit down Sunday q a yeah please try to catch us on
Wednesdays for a regular weekly scheduled content as well yeah and we'll see you guys next time bye
we're doctors but not your doctors anything we've said in this video
is for education or entertainment purposes only it is not medical
advice any specific medical questions you have should be directed to your provider