How Long Should You Wait Between Pregnancies?

New parents discuss having more children.

How close together would you like to have your children? Is it better to have them close together, so that you can get through the diaper stage all at once, or to spread them out so the older ones can help with the younger ones? If you have waited to start a family, do you have time to have more than two children? How far apart you space your children is a subjective decision, of course, but medical science does have some guidelines to offer. Beyond that, there are pros and cons to consider, no matter which way you’re leaning.

According to the World Health Organization (WHO), women should wait between 18 and 24 months between pregnancies. However, recent research published in JAMA Internal Medicine, women only need to wait a year between a birth and another pregnancy. A smaller gap than that can increase risks to the mother and baby, and the new findings indicate that waiting 12 to 18 months is optimal. This is great news for women over 35, who might be concerned about having more children as their maternal age advances. It’s important to wait at least 12 months between pregnancies, though, because becoming pregnant sooner than that increases the risk of maternal mortality, no matter the age of the mother. The risk is lower still at 18 months, so weigh this carefully when spacing your children.

Getting pregnant too quickly in succession is also risky for the baby. It increases the odds of premature birth, low rate, and small gestational age, all of which increase the risk of long-term health problems. Closely spaced pregnancies also have a higher risk of placental abruption, which results in a higher risk of fetal mortality and stillbirth.

Aside from the health of mom and baby, there are several other factors that you should consider when determining how far apart to space your pregnancies.

• How much of a gap do you want to have between your children? There is something to be said for having children who go through similar stages at the same time. They can share toys and gear, are likely to play together nicely, and as mentioned earlier, you can get through the diaper stage more quickly. On the other hand, being able to spend time alone with your newborn while your older child is in preschool is helpful. Having a “big” sibling who can help out with minor tasks, like bringing you a burp cloth or a new pack of wipes, can also be a boon.
• Consider your living space. Is there enough space for your children to have separate rooms? Will your older child be using the crib when your little one arrives? Will your children need to share space? Think about how you will situate the kids, along with any challenges you’ll face in the near future, like a move, that could make having a baby any time soon inconvenient.
• Think about the expense of a new baby. One benefit to having kids close together is that they can share much of the gear, and your older one will likely have hand-me-downs to pass along to the new baby. Consider, however, the expense of things like diapers and childcare, and make sure that having another child won’t put your family into a financial disadvantage.
• How do you feel about having another baby? Are you ready? Talk to your spouse so that you’ll know you’re on the same page. Your mental health and your instincts are both important, so trust your gut on whether or not this is the right time to bring another little person into your family.

The bottom line, of course, is that planning the spacing of your family is intensely personal. At the Center for Vasectomy Reversal, we love helping people grow their families. We pride ourselves on helping men improve their fertility through uncompromising, concierge-level patient care. Under the direction of Dr. Joshua Green, our team provides state-of-the-art treatment for men who need a reversal of their vasectomy or have other fertility concerns. To learn more, contact us through our website or call 941-894-6428.

How to Avoid Spoiling Your Kids

Parents playing with child.

They come into the world so little and sweet, and before you know it, your babies are turning into toddlers. Until now, it’s been pretty easy to manage them, but suddenly, they’re little people with minds of their own. You love them, you’d do anything for them, but how do you avoid spoiling them? We’ve got some tips to help you raise kids who are happy, secure, and definitely not spoiled.

• Set boundaries and stick to them. Being consistent is one of the most important parts of being a parent. Make sure the rules are clear, and use discipline strategies that work for your child. Remember, discipline needn’t be punitive. Try positive disciplinary practices like redirection and positive reinforcement. Expect your children to push your boundaries, it’s a normal part of child development, but resist the urge to cave when they do. It’s important to stick to your limits, or you could end up with a child who second guesses you at every turn. Teach your children that the rules are the rules, no means no, and there are consequences for bad behavior.
• Assign chores from an early age. Give your little ones age-appropriate chores, like putting away toys, setting the table, and putting plastic dinnerware in the sink. This will encourage your child to think about the needs of others, as well as instilling a sense of responsibility. Make it a rule that chores are done before fun; research indicates that children whose parents are strict about chores are better able to cope with frustration.
• Encourage good manners. Please and thank you should be some of your child’s first words, and saying thank you should become something your child does reflexively, without prompting. Good table manners, too, help a child become someone people want to be around. Teach your child to share, take turns, and respect the feelings of others, and not to be a sore loser or call names. Be a good example by being polite to the people you encounter in daily life, and teach your children how to write thank you notes to people who do nice things for them or give them gifts.
• Allow your little one to experience disappointment. Disappointment is a part of life. While it’s tempting to try to protect your child from the negative aspects of life, overprotecting can result in a spoiled child. Whether it’s a canceled playdate or not getting something he or she wants when you’re at the store, learning to face disappointment at an early age will serve your child well in the long run and help to develop coping skills.
• Foster compassion and a giving spirit. Make it your goal to raise a child who considers the needs of others and is compassionate and generous. Model this behavior by volunteering as a family, donating to charities, and letting your child see you being kind and giving to others. Children who put the needs of others first are less likely to be spoiled.
• Don’t give too many chances. We’ve all heard parents counting “2 ½ “, “2 ¾ “ before getting to three, and this is something to avoid if you don’t want spoiled kids. Failing to follow through on what you’ve said is going to happen, or dragging it out, can teach your children that they can manipulate you- and other people- to get what they want.
• Give kids the opportunity to work for what they want. Allow your child to make a case for the things he or she wants. If it’s watching a tv show, your child can explain the chores that have been done or offer to take a nap first. You can also let your children earn material things, like toys, through good behavior. To do this, set up a reward system to make your expectations clear.
• Don’t negotiate with terrorists… or toddlers. If your children think they can behave badly to get the things they want, they will do it. Don’t offer treats to squelch unpleasant behavior, or your child will expect every tantrum to end with a prize. Similarly, refrain from giving in to begging.
• Say yes whenever you can. If you’re always saying no, your children might begin to think you say no to everything, and this can lead to them thinking that bad behavior doesn’t matter, since they won’t get what they want anyway. Choose your battles, treat your child with kindness, and reward good behavior.

At the Center for Vasectomy Reversal, we love helping people grow their families. We pride ourselves on helping men improve their fertility through uncompromising, concierge-level patient care. Under the direction of Dr. Joshua Green, our team provides state-of-the-art treatment for men who need a reversal of their vasectomy or have other fertility concerns. To learn more, contact us through our website or call 941-894-6428.

Can Certain Medications Affect Your Sperm Health?

Man rethinking taking medication.

Often, infertility is assumed to be a woman’s problem. However, male infertility is also significant, and sperm quality can heavily impact the chances of conception. Many factors can affect male fertility, including excess weight, cigarette smoking, excessive drinking, and use of recreational drugs. While all of these factors are commonly known, what is less well known is that certain medication can interfere with male fertility.

How can medications affect a man’s fertility? Often, medication will decrease the production of sperm, but in some cases, medications will affect the function of the sperm itself. Decreased production leads to low sperm count, which means fewer sperm will be available to fertilize an egg. If a medication impacts the motility of the sperm, that means the sperm won’t move as efficiently and will have difficulty reaching the egg. Generally, once a man stops taking medication, it takes at least two or three months for his sperm to recover, since it takes that long for sperm to form and mature. With certain medications, however, it can take months or years for fertility to return to normal, and it might not return at all.

So, what types of medications have a negative impact on sperm? Over-the-counter medication does not usually cause an issue, as long as it’s taken correctly and in the proper dosage. However, it’s important to be cautious when you’re trying to conceive, so it’s wise to discuss any OTC medications with your doctor. Certain OTC medicines warrant particular caution:

• Non-steroidal anti-inflammatory drugs (NSAIDs) sometimes reduce fertility. According to a recent study, men taking 1,200 mg of ibuprofen daily can develop a hormonal condition that causes a problem, especially if the man is older. What was not made clear in the study is whether lower doses of ibuprofen can have the same effect. Additionally, while the effects are reversible when the medication is taken for short periods of time, it’s unclear whether they’re reversible if taken long-term.
• Natural or herbal remedies can cause problems for men trying to conceive. Because herbal remedies are not held to the same regulatory standards as medications, it’s better to stay away from them to protect fertility. Supplements that contain testosterone can be particularly problematic, so avoid anything that uses terms like “male enhancement,” “andro booster,” or “T-booster.”

There are prescription medications that can have a significant impact on fertility.

• Steroids and testosterone therapy can have a strong negative impact on sperm production. In fact, testosterone supplements will completely stop sperm production. Whether the man is taking anabolic steroids, herbal supplements with testosterone, or a prescription testosterone replacement from the doctor, the effect is the same. Testosterone blocks the body’s natural hormonal signals that cause the testicles to make sperm. The result is that the semen will either have a very low concentration of sperm or will have no sperm at all. This effect is reversible, but it takes a long time for the sperm to recover. In fact, it can take six to 12 months for sperm count to get back to normal.
• Chemotherapy can wipe out your sperm count. This is because chemo works by killing rapidly dividing cells, like cancer cells, but also, unfortunately, sperm cells. After cancer treatment, it’s common for men to have no sperm in the semen. However, natural fertility can return one to five years after the treatment is discontinued. If you’ve been through chemo, it’s best to wait at least two years before attempting to conceive. For some people, though, fertility never recovers. If you are about to start chemotherapy, talk to your doctor about freezing your sperm for later use.
• Blood pressure medications can decrease semen volume, sperm concentration, and sperm motility. These medications, especially calcium channel blockers, can also cause decreased libido and erectile dysfunction.
• Opioids can interfere with sexual performance and fertility. Long-term use, in particular, can disrupt the signals that control testosterone production. If you’ve only used opioids short-term, as for the treatment of a broken bone or when recovering from surgery, you may not need to worry.
• Antidepressants can cause a drop in libido and may negatively affect sperm production. Selective serotonin re-uptake inhibitors (SSRIs) are the most common medications used to treat depression and anxiety, and they can hinder your chances of conception. However, there are other medications your doctor or mental health provider can prescribe that won’t have the same impact.
• Other medications may be problematic if you’re trying to conceive. Antibiotics can interfere with testosterone and sperm production, especially an antifungal antibiotic called Ketoconazole. Biologics, used to treat autoimmune disorders, can reduce sperm count, and alpha-blockers, prescribed to treat the symptoms caused by an enlarged prostate, can inhibit ejaculation. 5-alpha-reductase inhibitors like Propecia® and Avodart®, used for hair loss and prostate enlargement treatment, can make it hard to conceive, but the effect goes away when you stop taking them. Anti-epilepsy medications, antiretrovirals, blood pressure medications, and some other medications can also cause fertility problems.

At the Center for Vasectomy Reversal, we are concerned with every aspect of men’s health, and we pride ourselves on helping men improve their fertility through uncompromising, concierge-level patient care. Under the direction of Dr. Joshua Green, our team provides state-of-the-art treatment for men who need a reversal of their vasectomy or have other fertility concerns. To learn more, contact us through our website or call 941-894-6428.