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Infertility
If you are trying to conceive without success, it is important to know that you are not alone. Having children is undoubtedly one of the greatest dreams for most couples.
Infertility affects approximately 1 in 6 couples worldwide. The term is used when pregnancy has not been achieved after 12 months of regular unprotected sexual intercourse or after 6 months when the woman is over the age of 35, as well as in cases where known factors may reduce the chances of conception.
Infertility is not a “failure” of the couple, but a medical condition that can often be treated. Today, there are many options and contemporary treatment methods that significantly increase the chances of achieving a successful pregnancy. The first and most important step is proper information — understanding the possible causes, the diagnostic process and the available treatment options.
Infertility may be caused by factors related to the woman, the man, or both partners. In a small percentage of cases, no clear cause is identified despite complete evaluation – this is referred to as unexplained infertility.
Female Factors Associated with Infertility
- Ovulation disorders: Absent or irregular ovulation is one of the most common causes of infertility. It may be related to polycystic ovary syndrome (PCOS), thyroid or prolactin disorders or diminished ovarian reserve (DOR).
- Blocked or damaged fallopian tubes: The fallopian tubes are essential for the egg and sperm to meet in order for fertilization to occur. Conditions such as pelvic infections (e.g. salpingitis), previous surgeries or endometriosis may cause tubal blockage, making natural conception difficult or impossible.
- Endometriosis: A condition in which tissue similar to the endometrium grows outside the uterus, affecting the function of the ovaries and fallopian tubes.
- Age and diminished ovarian reserve: After the age of 35, both the quality and number of eggs naturally decline.
Male Factors Associated with Infertility
- Semen abnormalities: A low sperm count, reduced sperm motility or abnormal sperm morphology may impair fertilization.
- Obstructions or anatomical abnormalities: Such as obstruction of the spermatic ducts or varicocele.
- Hormonal or genetic causes: Less common, but still significant causes of male infertility.
Even when all test results are normal, no specific cause is identified in approximately 10–20% of couples. Nevertheless, effective treatment options with good success rates are still available.
A thorough evaluation is the first and most important step in fertility treatment. At our practice, special emphasis is placed on identifying the underlying causes of infertility before initiating any treatment. Combined with a detailed medical history, this allows the development of the most appropriate and individualized treatment strategy.
Female Fertility Testing
- Transvaginal ultrasound for the examination of the uterus and ovaries
- Hormonal testing (FSH, LH, estradiol, TSH, prolactin, AMH)
- Conventional hysterosalpingography (HSG) or ultrasound hysterosalpingo-foam sonography (HyFoSy) to assess tubal patency
- Laparoscopy
- Screening for sexually transmitted infections (STIs)
Male Fertility Testing
- Semen analysis
- Semen culture
- DNA Fragmentation Index (DFI) test
- Hormonal evaluation
- Screening for sexually transmitted infections (STIs)
The fertility evaluation is usually completed within 1–2 menstrual cycles. Based on the findings, an individualized and scientifically evidence-based treatment plan is designed.
Women’s health
Pediatric and adolescent gynecology is a specialized branch of medicine that focuses on the health of the female reproductive system from birth through adolescence and into early adulthood. Its aim is the prevention, early diagnosis and treatment of conditions that may affect the physical and emotional development of children and adolescents.
During childhood, common issues include congenital abnormalities, infections, labial adhesions and pubertal disorders. During adolescence, gynecological care focuses on the normal onset and development of menstruation, menstrual irregularities, period pain, acne, as well as sexual health and contraception.
The first visit to a gynecologist should take place in a calm and supportive environment, with respect for the patient’s age and privacy. Proper guidance for both the adolescent and her family helps build a relationship of trust and encourages healthy attitudes toward the body and reproductive health.
Pediatric and adolescent gynecology lays the foundation for a healthy adult life through early prevention and medical care.
The annual gynecological check-up is an essential part of preventive healthcare and overall well-being for every woman, regardless of age or the presence of symptoms. Many gynecological conditions develop without noticeable signs in their early stages, making regular monitoring particularly important.
Depending on a woman’s age, medical history and individual needs, the examination may include a Pap test, HPV test, pelvic ultrasound and breast examination. The goal is the early detection of cervical abnormalities, ovarian cysts, fibroids or other conditions that may affect gynecological and general health.
Beyond its diagnostic role, the annual check-up provides an opportunity to discuss concerns related to the menstrual cycle, contraception, sexually transmitted infections, family planning and hormonal changes during different stages of life.
Prevention is always more effective than treatment. Through regular gynecological examinations, many conditions can be diagnosed and managed at an early stage using simpler and less invasive methods. Consistent follow-up contributes to maintaining health, quality of life and emotional well-being.
The Human Papillomavirus (HPV) is an extremely common virus with more than 200 different types. It is primarily transmitted through sexual contact and the majority of sexually active individuals will be exposed to the virus at some point in their lives.
In the majority of cases, the body’s immune system eliminates the virus naturally without complications. However, certain high-risk HPV types may persist and lead to precancerous lesions or cervical cancer, if not diagnosed and treated early.
Because HPV infection usually causes no symptoms, preventive gynecological screening plays a crucial role. The Pap test and HPV test allow the detection of cellular abnormalities or the presence of the virus before they develop into a serious condition.
HPV vaccination is currently the most effective method of prevention. It protects against the most common and high-risk types of the virus and is recommended for both girls and boys before the onset of sexual activity, as well as for adult women. Even women who have already been exposed to HPV may still benefit from vaccination, as it can provide protection against virus types they have not previously encountered.
Vaccination does not replace regular gynecological screening, but complements it. The combination of vaccination and preventive care is the most effective strategy for reducing HPV-related diseases.
The menstrual cycle is an important indicator of a woman’s hormonal and reproductive health. A normal cycle is characterized by relatively regular intervals and bleeding of normal duration and intensity.
Menstrual disorders are common and may occur at any age. They can include infrequent or very frequent periods, absence of menstruation, heavy or prolonged bleeding, as well as significant menstrual pain. In many cases, these disorders can affect a woman’s daily life and overall quality of life.
The causes vary and may include hormonal imbalances, severe stress, changes in body weight, eating disorders, polycystic ovary syndrome (PCOS), thyroid disorders and structural abnormalities of the uterus or ovaries.
The evaluation of menstrual disorders is based on a detailed medical history, clinical examination, ultrasound assessment, and, when necessary, blood tests. Treatment is individualized and depends on the underlying cause, the woman’s age and her reproductive needs.
Early evaluation helps restore hormonal balance, improve symptoms and prevent future complications. Any persistent change in the menstrual cycle should be assessed by a gynecologist.
Menopause is a natural stage in a woman’s life and is defined as the permanent cessation of menstruation. It usually occurs between the ages of 45 and 55 and is preceded by the perimenopausal period, during which gradual hormonal changes take place.
The decline in estrogen levels may cause a variety of symptoms including hot flashes, night sweats, sleep disturbances, mood changes, fatigue, reduced libido and vaginal dryness. The severity and duration of symptoms vary significantly from woman to woman.
Beyond the immediate symptoms, menopause is associated with long-term changes affecting bone health, the cardiovascular system and the metabolism. For this reason, appropriate medical follow-up is particularly important.
Modern medicine offers many treatment options, both hormonal and non-hormonal, which can significantly improve quality of life when indicated. Any treatment decision is made following an individualized evaluation, taking into account the woman’s medical history and personal needs.
Menopause is not a disease but a new stage of life. With proper information, prevention and support, it can be experienced with balance, safety and a good quality of life.
Contraception is an essential part of reproductive health and family planning. Today, a wide range of contraceptive methods is available, allowing every woman to choose the option that best suits her personal needs and lifestyle.
Contraceptive methods include hormonal options such as oral contraceptive pills, the vaginal ring and transdermal patches, as well as non-hormonal solutions such as intrauterine devices (IUDs) and barrier methods. Different contraceptive methods act through different mechanisms, advantages and possible limitations.
Choosing the appropriate method of contraception is not only about preventing an unplanned pregnancy. In many cases, contraception may also help regulate the menstrual cycle, reduce period pain or manage heavy bleeding.
Proper counseling and individualized guidance from a gynecologist are essential to ensure that the chosen method is both safe and effective. Factors such as age, medical history, smoking and future reproductive plans are always taken into consideration.
Contraception is a personal choice and should be tailored to each woman’s individual needs, with the goal of promoting health, safety and autonomy.
Vaccination during pregnancy is now considered one of the most important ways to protect both the mother and the newborn. According to current international guidelines, certain vaccines are completely safe during pregnancy and provide significant benefits.
During pregnancy, a woman’s immune system undergoes natural changes which may increase the risk of severe illness from certain infections. At the same time, during the first months of life, newborns have not yet developed full immune protection. Maternal vaccination allows protective antibodies to pass to the fetus through the placenta, providing valuable protection after birth.
Influenza Vaccine
The influenza vaccine is recommended for all pregnant women, regardless of trimester, during flu season. Influenza during pregnancy may lead to serious complications for both the mother and the fetus. Vaccination significantly reduces the risk of severe illness, hospitalization and complications, while also protecting the newborn during the first months of life.
Pertussis Vaccine
Pertussis (whooping cough) is particularly dangerous for newborns, especially during the first months of life, before they complete their own vaccination schedule. For this reason, vaccination with the combined tetanus–diphtheria–pertussis (Tdap) vaccine is recommended during the third trimester of pregnancy. This allows the newborn to receive passive immunity and immediate protection after birth.
RSV Vaccine
Respiratory Syncytial Virus (RSV) is a common cause of severe lower respiratory tract infections in infants. Recent evidence supports vaccination during pregnancy in order to protect newborns during the first critical months of life. Maternal vaccination helps reduce the risk of severe infection and hospitalization in infants.
Vaccination during pregnancy is safe, well studied and an important part of prenatal care. Individualized counseling and discussion with the gynecologist help every pregnant woman make informed decisions regarding her own health and the health of her baby.
Pregnancy
Prenatal screening is an essential and integral part of pregnancy care. It includes a series of examinations performed both before and during pregnancy, with the aim of safeguarding the health of the mother and the fetus, while allowing the early identification of possible risks.
Prenatal screening tests are tailored to each trimester of pregnancy. They may also be performed before conception, contributing to appropriate family planning.
The selection and frequency of these tests are determined on an individualized basis, in collaboration with the physician, in order to ensure the best possible care for both the mother and the fetus.
Before Pregnancy or During the First Trimester
- Blood tests: Complete blood count, biochemical testing, blood group and Rhesus (Rh) factor screening, as well as testing for infections (rubella, toxoplasmosis, CMV) and sexually transmitted diseases (hepatitis B/C, HIV, syphilis). Blood tests are performed throughout pregnancy, usually once per month.
- Hemoglobin electrophoresis for the diagnosis of inherited hemoglobin disorders (thalassemia, sickle cell anemia)
- Genetic screening based on family history (cystic fibrosis, thrombophilia)
- Thyroid function testing
- Vaginal culture and Pap test
- Ultrasound examination to confirm an intrauterine pregnancy and fetal cardiac activity, performed between the 6th and 10th week of pregnancy
- Nuchal translucency scan, performed between the 11th and 14th week, combined with the PAPP-A blood test, for the assessment of the risk of chromosomal abnormalities and the prediction of preeclampsia
- Non-Invasive Prenatal Testing (NIPT), performed after the 10th week of pregnancy. This is a simple and safe maternal blood test that analyzes cell-free fetal DNA and assesses, with high accuracy, the risk of common chromosomal abnormalities such as Down syndrome. It poses no risk to the fetus and is considered a reliable prenatal screening tool.
- Measurement of body weight and blood pressure at every gynecological visit, throughout all trimesters
During the Second Trimester
- Blood tests
- Second-trimester ultrasound scan (Level II ultrasound), performed between the 20th and 24th week, to evaluate fetal anatomy and growth, the amount of amniotic fluid, and the position and maturation of the placenta
- Fetal echocardiography for the detailed evaluation of fetal heart anatomy and function, as well as the detection of congenital or other cardiac abnormalities. The examination is performed by a specialized fetal cardiologist. According to current guidelines, it is now mandatory in pregnancies achieved through IVF.
- Oral glucose tolerance test (OGTT) between the 24th and 28th week, for screening of gestational diabetes, regardless of risk factors or indications.
During the Third Trimester
- Fetal growth scan and Doppler examination, performed between the 28th and 40th week, to assess fetal growth, amniotic fluid volume, placental position and blood flow in the umbilical artery, middle cerebral artery, and uterine arteries.
- Cardiotocography (CTG), which records fetal movements, fetal heart rate and uterine contractions, while also monitoring changes in fetal heart rate during different phases such as sleep, wakefulness or uterine contractions. The examination may be repeated multiple times after the 28th week of pregnancy.
- Laboratory tests
- Screening for Group B beta-hemolytic Streptococcus through vaginal culture between the 35th and 37th week of pregnancy
Pregnancy is a period of profound change — physical, hormonal and emotional. The body changes, nutritional needs evolve and, along with them, a woman’s relationship with food may also shift. It is a stage characterized by intense physical, hormonal and metabolic adaptations, during which nutrition becomes especially important. A pregnant woman’s dietary choices directly affect both her own health and the healthy development of the fetus, from the early stages of pregnancy through childbirth. At this stage, nutrition is not simply about “what is allowed” and “what is forbidden,” but about the overall care and wellbeing of both mother and baby.
During pregnancy, nutritional needs are not the same for every woman. Pre-pregnancy weight, the progression of the pregnancy, possible symptoms and each woman’s daily routine, all play a determining role. For this reason, there is no “magic” solution or general plan that fits everyone. Personalization is a fundamental element of proper nutritional support. At the same time, nutrition contributes to healthy weight gain during pregnancy, which varies depending on body weight before conception. Both excessive and insufficient weight gain may affect the course of the pregnancy and increase the risk of complications.
Many women are also faced with conflicting information and nutritional myths. Advice from family and friends, the experiences of other pregnant women and content on social media often create confusion and insecurity. As a result, some women become overly restrictive with food, while others feel that they are “doing something wrong” without any real reason.
The psychological aspect of pregnancy is equally important. Changes in the body, weight gain and changes in physical appearance may cause anxiety or discomfort, even in women who previously had a positive relationship with their bodies. Nutritional support during this phase is not aimed at control, but at understanding, acceptance and caring for the body that is creating life.
Nutritional care during pregnancy is not an isolated intervention but part of a broader continuum of care, that begins before conception and continues after childbirth. Collaboration with a specialized Dietitian–Nutritionist allows nutrition to be adapted to every stage — before pregnancy, during pregnancy and postpartum — supporting the mother while laying strong foundations for the child’s long-term health.
At Prolific, pregnancy support is approached as a continuous and individualized process. Nutrition is tailored to each woman’s needs, taking into account both her physical and emotional state. The goal is safety, balance and support at every stage of pregnancy, without guilt and without rigid rules.
Pregnancy does not require “perfect” choices but proper guidance. With the right support, a woman can feel confident in her choices and trust her body, laying the foundations for both her own health and the care of her child.
A full-term pregnancy lasts approximately 40 weeks, calculated from the first day of the last menstrual cycle. Pregnancy is divided into three trimesters. During each stage, the baby develops rapidly while the mother’s body continuously adapts. Proper information and regular medical follow-up are key to a healthy pregnancy.
FIRST TRIMESTER (Weeks 1–13)
The early stages of pregnancy are characterized by the rapid development of the baby’s major organs. During the early pregnancy ultrasound, usually performed between the 6th and 9th week, you will hear the baby’s heartbeat for the first time, while the embryo develops rapidly. Be prepared for symptoms such as fatigue, nausea, vomiting, breast tenderness, drowsiness and mood changes.
It is important to pay close attention to proper nutrition and to avoid smoking and alcohol consumption. You should also discuss the use of any medication with your doctor. Once the pregnancy is confirmed, you will begin taking folic acid supplements.
SECOND TRIMESTER (Weeks 14–28)
Your baby continues to grow, move more actively, and its organs continue to mature. Toward the end of the trimester, you will begin to feel fetal movements. In general, you may start feeling better, with more energy and less nausea, while your abdomen gradually becomes more noticeable. You may also experience discomfort such as lower back pain or muscle cramps.
This is the ideal period to discuss childbirth preparation classes, which are an important part of prenatal care, especially for first-time parents. At the same time, you may also receive information about newborn care programs.
THIRD TRIMESTER (Weeks 29–Delivery)
Your baby gains weight rapidly, especially toward the end of the trimester. The lungs continue to mature as the baby prepares for birth. As the weeks progress, you may experience increased fatigue, frequent urination and shortness of breath. Preparatory contractions (Braxton Hicks contractions) may also begin.
As your pregnancy advances, your visits to the doctor will become more frequent. From the 36th week onward, appointments are usually scheduled weekly.
At the beginning of the trimester, your doctor will determine whether the baby is in a head-down position (cephalic position). If the baby is in breech position (buttocks down), there is still time for the position to change. During the third trimester, particular attention is also given to signs of preeclampsia, a complication that may appear from the second trimester but is more common during the final weeks of pregnancy.
In the last weeks of pregnancy, your doctor may perform a vaginal examination to assess the condition of the cervix (consistency, position, effacement and dilation) and estimate the timing of delivery. You will also discuss the planned mode of delivery, whether vaginal birth or cesarean section.
As your due date approaches, you can discuss how to recognize the signs of labor and prepare for childbirth, breastfeeding and newborn care.
Pregnancy is a unique experience. With proper medical care and guidance, every stage can be experienced with safety and reassurance. Remember that whenever you have concerns or questions, your doctor and medical team are there to support and guide you.
Labor and delivery
Labor and delivery mark the natural completion of pregnancy and the moment when the baby enters the world. Every birth experience is unique and may take place either through vaginal delivery or cesarean section, with the primary goal always being the safety of both mother and newborn.
Signs of Labor
Recognizing the signs of labor early can help the expectant mother feel more prepared and reassured, always in collaboration with her attending physician.
- Regular Uterine Contractions
Contractions are the most characteristic sign of labor onset. Unlike Braxton Hicks contractions, labor contractions are regular and become progressively more frequent. They are stronger and more painful, do not subside with rest and lead to gradual cervical dilation.
- Rupture of Membranes (“Water Breaking”)
The rupture of the amniotic sac surrounding the baby may occur either as a sudden gush of fluid or as a continuous leakage. The fluid is usually clear and odorless and may feel similar to urine leakage. Even in the absence of contractions, water breaking is a reason for immediate communication with your doctor or prompt arrival at the maternity hospital.
- Bloody Show
If you notice blood-tinged mucus discharge, there is usually no reason to panic. This is caused by the gradual dilation of the cervix and the release of the mucus plug. It is a sign that labor is approaching, although it does not always indicate immediate onset. In any case, you should contact your doctor for further instructions.
Additional indications of labor may include a strong feeling of pelvic pressure, intense lower abdominal or lower back pain similar to menstrual cramps, nausea, diarrhea and increased urination.
In Summary, You Should Contact Your Doctor Immediately If:
- contractions become regular and painful
- your “waters” rupture
- vaginal bleeding occurs
- fetal movements decrease
The Stages of Labor
Labor normally progresses through three distinct stages, describing the gradual preparation for birth, the delivery of the baby and the completion of the process.
Labor progression differs for every woman. For first-time mothers, labor may last on average between 8 and 15 hours, although this is not always the case.
Knowing what to expect at each stage can help labor progress more smoothly.
- First Stage – Cervical Dilation
The first stage of labor is divided into two phases: the latent phase and the active phase.
Latent Phase
This is usually the longest phase of labor. It begins with mild and irregular contractions that gradually become more frequent and intense, while the cervix slowly dilates to approximately 3–4 centimeters.
Active Phase
Contractions become stronger and more painful, while cervical dilation progresses more rapidly, reaching approximately 4–7 centimeters.
When the cervix reaches 8–10 centimeters of dilation (complete dilation), labor enters the “transition phase,” the final part of the first stage of labor. This is the most demanding phase, characterized by very intense and frequent contractions and significant pain.
- Second Stage – Pushing
The second stage begins when the cervix is fully dilated to 10 centimeters and ends with the birth of the baby. This stage may last from a few minutes up to two hours. During this time, contractions usually last longer than one minute and occur every two to three minutes.
The mother actively participates by pushing, guided by the midwife and physician. The baby’s head gradually descends through the birth canal until the head is delivered first, followed by the rest of the body.
As the baby’s head descends, you may feel pressure in the rectal area and a strong urge to push. Pushing is often performed with three pushes during each contraction following one deep breath.
If necessary, an episiotomy may be performed — a small incision between the vagina and rectum to facilitate delivery. After birth, the baby is immediately placed on the mother’s chest for skin-to-skin contact.
- Third Stage – Delivery of the Placenta
This is the shortest stage of labor and involves the separation and delivery of the placenta and fetal membranes. It begins immediately after the birth of the baby and usually lasts between 5 and 30 minutes.
Contractions continue with less intensity, helping the placenta detach and be expelled. Once the process is complete, the doctor checks that the placenta has been fully delivered and that the uterus is contracting properly in order to prevent complications.
At this point, labor is safely completed and the postpartum period begins.
ΣIn a cesarean section, the baby is delivered through surgical incisions made in the mother’s abdomen and uterus. It is a safe and well-established medical procedure performed when vaginal delivery is not possible or may pose risks. A cesarean section may be either planned or performed as an emergency procedure for the immediate safety of the mother and baby.
The procedure is relatively short and is usually performed under epidural anesthesia, allowing the mother to see her baby immediately after birth. The doctor makes an incision in the lower abdomen and then in the uterus, through which the baby is delivered.
Cesarean delivery offers safety in cases of complications and allows better control of the delivery process. However, as with any surgical procedure, it is associated with postoperative pain, longer recovery time and potential complications.
Vaginal Delivery or Cesarean Section?
When there are no medical indications, vaginal delivery is generally considered the preferred option, as it is associated with faster recovery and fewer interventions. Cesarean section is necessary and life-saving when required for the safety of the mother or baby.
The final decision is always made on an individualized basis, in consultation with the attending physician.
A few days before delivery, it is helpful to prepare a hospital bag so that you feel more organized and reassured.
For hospital admission, you will need basic identification and insurance documents such as your ID card, social security number and health insurance booklet or insurance card. Required documents usually concern both parents and are requested upon arrival at the maternity hospital.
For the mother, comfortable clothes and nursing-friendly nightwear are recommended, along with a robe, slippers and underwear. A toiletry bag with personal hygiene items, towels, maternity pads and anything that helps you feel comfortable will also be useful.
For the baby, only clothes for leaving the hospital are usually required, as most private maternity hospitals provide clothing and newborn care during hospitalization. Finally, it is important to have the baby car seat ready for a safe journey home.
Proper preparation allows you to focus on this important moment with greater calmness and fewer unnecessary worries.
With the baby at home
Breastfeeding is a completely new yet unique experience. In the beginning, guidance is often needed to help position the baby correctly at the breast. With the support of the midwife and maternity staff, you will succeed. All new mothers produce milk; the key is frequent breastfeeding. The more often you breastfeed, the greater your milk production will be.
The first breastfeeding session
The first breastfeeding session is a very important moment for both the baby and the mother. It takes place within the first hour after birth, whether following a vaginal delivery or a cesarean section, with immediate skin-to-skin contact. This strengthens the emotional bond between mother and baby, giving the newborn a sense of security while helping regulate body temperature and breathing.
The baby’s suckling stimulates the release of hormones that promote breast milk production and flow, while also helping the uterus contract after delivery. In addition, during the first feeding the baby receives colostrum, which is especially rich in antibodies and acts as the baby’s first natural vaccination, while also helping regulate blood sugar levels.
Rooming-In
Keeping mother and baby in the same room throughout the maternity hospital stay facilitates on-demand breastfeeding, increases milk production, and promotes exclusive breastfeeding. At the same time, whenever the mother needs rest, the baby can still be cared for in the nursery.
What to expect during the first days
- First 24 hours:
The baby sleeps a lot and consumes small amounts of colostrum (5–7 ml). Despite its small quantity, colostrum is rich in carbohydrates, proteins, antibodies, and fats, all essential and sufficient for the newborn. Even if the baby does not seem hungry, this is normal. Breastfeed every 3 hours or sooner if hunger cues appear (turning the head, opening the mouth, rooting sounds). - Second 24 hours – “Cluster feeding”:
Babies may want to breastfeed continuously, become unsettled when separated from the mother, and seem difficult to soothe unless they are at the breast. This is normal and helps stimulate milk production. - Third–Fourth 24 hours – Possible physiological jaundice:
The baby may become sleepier, feed less eagerly, and develop a yellowish skin tone due to increased bilirubin levels in the blood. This is a normal process experienced by many newborns. Good hydration through frequent breastfeeding is helpful. A laboratory blood test obtained from a small heel-prick sample will determine bilirubin levels and whether measures such as phototherapy are needed.
Correct positioning helps prevent pain and improves milk flow. Make sure the baby is tummy-to-tummy with you and that the neck remains aligned with the rest of the body (ear–shoulder–hips).
Common breastfeeding positions include:
Cross-Cradle Hold
Recommended for newborns and first-time mothers. Sit comfortably with your back and legs supported at a right angle, and bring the baby close so you are “tummy-to-tummy.” A nursing pillow may help.
Support the baby’s head at the neck with one hand, while offering the breast with the other hand. Always bring the baby to the breast, not the breast to the baby. Expressing a small drop of milk may encourage the baby to latch. Wait until the baby opens the mouth wide to achieve a deep latch and avoid nipple injury.
Cradle Hold
A classic breastfeeding position. The baby’s head rests in the inner elbow while the other hand supports the breast, keeping the baby close to the chest. A pillow may provide additional support.
Care should be taken because head positioning is less controlled, increasing the risk of nipple soreness. Mothers with larger breasts should ensure the baby’s nostrils remain unobstructed.
Football Hold (“Rugby Ball”)
A good option after cesarean section or for mothers with larger breasts. Sit comfortably and place a pillow under your arm. Position the baby at your side with the head at the breast and the legs pointing toward your back. Support the neck gently to help the baby latch effectively.
Side-Lying Position
A comfortable position for nighttime breastfeeding and rest. Lie on your side facing the baby “tummy-to-tummy,” with pillows supporting your back and possibly between your knees. One hand may support the baby while the other helps guide the latch.
While breastfeeding, it is important to maintain a balanced diet rich in fluids, proteins, vitamins, and carbohydrates. Gradually include legumes and green vegetables, and avoid foods that may significantly alter the taste or smell of breast milk, such as excessive spices and very spicy foods.
One cup of coffee per day is generally acceptable, preferably after breastfeeding. Alcohol should be limited to one drink per week, and breastfeeding should be avoided for approximately 3 hours afterward. Smoking is not recommended during breastfeeding.
Low milk supply may result from primary causes (biological, anatomical, or medical conditions) or secondary causes, such as infrequent breastfeeding or inadequate breast emptying. Frequent breastfeeding and support from a midwife or lactation consultant are usually helpful.
You may notice engorgement when the breast remains hard or feels insufficiently emptied after feeding. The breast may become heavy, warm, red, and painful. Engorgement often occurs when the baby consumes less milk than the breast is producing.
Management includes a warm shower and warm compresses before breastfeeding, circular breast massage, and cold compresses afterward.
A breast pump may be useful when the breast remains full after feeding or has not emptied adequately. Pumping may also help with inverted or flat nipples, sore nipples, latching difficulties, or prematurity. In any case of difficulty, contact your midwife or lactation consultant.
Nipple irritation can be painful and may discourage continued breastfeeding.
To prevent nipple injury, focus on achieving a deep latch involving the areola rather than just the nipple tip. If injury occurs, apply a few drops of breast milk to the nipple and allow it to air dry. Breast milk has antimicrobial and healing properties.
Special healing creams and silicone nipple shells may also help by allowing airflow and preventing friction from clothing. Despite irritation or injury, try to continue breastfeeding whenever possible.
Mastitis may occur when milk remains in the breast for prolonged periods, when the breast does not empty properly, or due to bacteria entering through the milk ducts.
Symptoms: heavy, hard, red, swollen, painful breast and fever, sometimes reaching 40°C.
Treatment: breast emptying (through breastfeeding or pumping) and antibiotics compatible with breastfeeding.
The inflammation affects the breast tissue, not the milk itself. Breastfeeding can and should usually continue safely.
When there is excess breast milk and a breast pump is used, creating a home breast milk supply can allow the baby to continue benefiting from breast milk even after breastfeeding has stopped.
Milk may be safely stored in sterilized containers in the back of the refrigerator at 4°C for up to 4 days. If not used immediately, it may be frozen in special breast milk storage bags at -18°C to -20°C for up to 6 months. Each container should be labeled with the date and time of expression.
For use, thaw milk ideally in the refrigerator over approximately 24 hours. Warm it using a bottle warmer or warm water bath. Any leftover warmed milk should be discarded.
If the baby is breastfeeding directly, bottle use should ideally be minimized to avoid interfering with breastfeeding skills; milk may instead be given by syringe if recommended.
All bottles, nipples, pacifiers, and pump parts should be thoroughly cleaned with baby-safe soap and sterilized carefully.
A newborn’s skin may appear mildly dry, which is considered normal. Gentle moisturizing products, preferably natural oils such as almond oil, may be applied with gentle massage.
The eyes should be cleaned with sterile gauze and saline solution, wiping toward the outer corner of the eye. Use separate gauze for each eye.
The nose may be cleaned with saline while the baby lies on the side.
The umbilical cord stump requires special care. Clean it with gauze and alcohol at every diaper change until it falls off, usually within the first two weeks. Continue cleaning for one additional week after separation.
Ears should only be cleaned externally with a towel after bathing; cotton swabs should not be used.
Nails are best trimmed while the baby is asleep, using a baby nail file.
Bathing & techniques
Until the umbilical cord falls off, the baby should be bathed while being held, usually over a sink, rather than submerged in a bathtub. Getting the cord wet is not a problem as long as it does not remain soaked.
Daily bathing is ideal, preferably in the evening before breastfeeding, as it helps the baby relax and sleep more easily.
The water temperature should be approximately 37°C (body temperature). The baby should not be placed directly under running water; instead, gently pour water using your hand or a small cup.
After bathing, dry the baby carefully, paying particular attention to skin folds to prevent irritation.
The postpartum period is not only a time of physical recovery but also a profound psychological transition. A woman takes on a new identity as a mother, while her body and daily roles change significantly.
Mood changes (“baby blues”), crying spells, exhaustion, anxiety, emotional sensitivity, and a heightened sense of responsibility are common and usually temporary.
Support from partners, family, friends, and healthcare professionals plays a crucial role in emotional balance and recovery.
Postpartum Depression
Approximately 1 in 7 women may experience postpartum depression during the first months after childbirth. It is not a sign of weakness or poor motherhood, but rather the result of biological, hormonal, and psychosocial factors.
Symptoms may include:
- persistent sadness or emptiness,
- severe anxiety or irritability,
- lack of energy or interest,
- difficulty bonding with the baby,
- sleep or appetite disturbances,
- feelings of guilt or inadequacy.
Postpartum depression is treatable. Early recognition and support are essential.
When to seek help (“Red Flags”)
Contact a healthcare professional immediately if you experience:
- persistent sadness lasting more than two weeks,
- loss of interest in previously enjoyable activities,
- difficulty caring for yourself or the baby,
- severe anxiety, panic attacks, or hopelessness,
- thoughts of self-harm or harm to the baby,
- withdrawal from your partner, family, or friends.
You are not alone. Support is available and effective.
Self-care tips during the postpartum period
Caring for the baby begins with caring for the mother.
Rest is essential. Sleep whenever the baby sleeps, limit visitors during the first days, and accept help without guilt.
Stay hydrated and maintain proper nutrition, especially while breastfeeding.
Gentle movement such as short walks and light stretching may improve energy and mood. Avoid intense exercise without medical guidance.
Take care of your body by following hygiene instructions for the perineum or cesarean incision and wearing comfortable cotton clothing.
Do not hesitate to ask for help or share daily responsibilities. Set boundaries regarding unsolicited advice and focus on supportive people around you.
Bonding with your baby develops gradually through cuddling, skin-to-skin contact, and eye contact. Do not pressure yourself.
Even a few minutes each day for relaxation — a shower, music, or reading — can make a difference.
Hormonal changes may affect mood; emotional ups and downs are normal.
Finally, maintain open communication with your partner and share your thoughts and concerns openly.
The father’s role during the postpartum period is extremely important — not only for the mother, but also for the baby and the overall harmony of the family.
After childbirth, the mother experiences hormonal changes, physical exhaustion, and emotional fluctuations. The father can provide support through presence, empathy, patience, and calmness.
At the same time, fathers develop their own bond with the baby through skin-to-skin contact, cuddling, and active participation in baby care.
This involvement gives the mother valuable time to rest, recover, and adjust. The father’s support helps create a safe, calm, and nurturing family environment.
