Cow's milk: When and how to introduce it to babies

In this article

• Why do experts recommend waiting to introduce cow's milk until a baby is 12 months old?
• How much milk should my toddler drink?
• Can I give my toddler fat-free or reduced-fat milk?
• My toddler doesn't seem to want cow's milk. Any tricks I can try?
• What if my child doesn't like any dairy products? What if he has an allergy or if we're vegans?
• Should I buy organic or hormone-free milk for my child?
• Could my child have a milk allergy?

Reviewed by the BabyCenter Medical Advisory Board

Last updated: August 2012

Why do experts recommend waiting to introduce cow's milk until a baby is 12 months old?

There are several reasons to delay the introduction of cow's milk until your baby reaches his first birthday.
Babies can't digest cow's milk as completely or easily as breast milk or formula. Cow's milk contains high concentrations of protein and minerals, which can tax your baby's immature kidneys. In addition, cow's milk doesn't have the right amounts of iron, vitamin C, and other nutrients for infants. It may even cause iron-deficiency anemia in some babies, since cow's milk protein can irritate the lining of the digestive system, leading to blood in the stools. Finally, cow's milk doesn't provide the healthiest types of fat for growing babies.

 

How to store and use breast milk

Find out how to safely store breast milk in the fridge or freezer and how to prepare it for feeding to your baby.

Once your child's ready to digest it, though, milk becomes an important part of his diet. It's a rich source of calcium, which builds strong bones and teeth and helps regulate blood clotting and muscle control. And it's one of the few sources of vitamin D, which helps the body absorb calcium and is crucial for bone growth. Almost all milk in the U.S. is fortified with vitamin D. (Ultraviolet rays are another source, but they're blocked by sunscreen.)
Milk also provides protein for growth, as well as carbohydrates, which will give your child the energy he needs to toddle all day. And if your child gets enough calcium from the get-go, there's evidence that he'll have a lower risk of high blood pressure, stroke, colon cancer, and hip fractures later in life.

How much milk should my toddler drink?

According to the American Academy of Pediatrics (AAP), most kids will get enough calcium and vitamin D if they drink 16 to 20 ounces (2 to 2 1/2 cups) of cow's milk a day. Offer 1-year-olds whole milk (unless they're at high risk for obesity).
Don't offer more than 3 cups of milk a day or your child may not have room for the other foods she needs to round out her diet. If your toddler's still thirsty, offer water.

Can I give my toddler fat-free or reduced-fat milk?

In most cases, not yet. The AAP recommends whole milk for 1-year-olds. Children this age need the higher fat content of whole milk to maintain normal weight gain and to help the body absorb vitamins A and D. And nonfat milk provides too high a concentration of protein and minerals for children this age. Once your child turns 2, you may decide to switch him to reduced-fat or nonfat milk as long as he's growing well.
Possible exceptions: If you're overweight or obese, or have a family history of obesity, high cholesterol, or cardiovascular disease, your child's doctor may recommend giving him reduced-fat milk (2 percent) after age 1.

My toddler doesn't seem to want cow's milk. Any tricks I can try?

Some toddlers greedily gulp cow's milk right off the bat. But because milk has a different texture, taste, and even temperature than breast milk, some kids are hesitant to make the switch.
If that's the case for your toddler, try mixing milk with some breast milk or formula at first (say, one part milk and three parts of her usual stuff). Then slowly shift the ratio until she's drinking 100 percent milk. It may also help to serve the milk at room temperature.
Meeting the minimum requirement of 2 cups can be a challenge if your child doesn't care for milk. But there are many ways to get milk into your child's diet: Add it to her cereal. Serve yogurt, cottage cheese, pudding, custard, or shakes for snacks. Make soup with milk rather than water. Add a milk-based sauce or gravy to casseroles.

What if my child doesn't like any dairy products? What if he has an allergy or if we're vegans?

If your child isn't getting enough calcium and vitamin D from milk and other dairy products, perhaps because he can't tolerate them or your family is vegan, your pediatrician will probably recommend calcium and vitamin D supplements.

Should I buy organic or hormone-free milk for my child?

There's no conclusive evidence that these kinds of milk are better for children, but there's no harm in them. (Organic milk does tend to be more expensive.) Read up on growth hormones in milk and organic foods to help you make a decision.
The AAP warns against giving your child "raw" or unpasteurized milk, though. Without pasteurization, milk may contain harmful bacteria or parasites that can cause serious illness or even death.

Could my child have a milk allergy?

True allergies to cow's milk are relatively uncommon. Only 2 to 3 percent of children are allergic to milk, according to the AAP, and almost all of them outgrow it by age 3. (Learn the difference between a milk allergy and lactose intolerance.)
If your child drank cow's-milk-based formula as a baby without any problems, you can rest assured that she'll have no problems tolerating regular cow's milk. Even babies who were exclusively breastfed for the first year can usually handle regular cow's milk because they've been exposed to cow's milk protein in their mother's milk (unless their mother avoided all dairy).
If your child drank soy formula because your doctor recommended it, though, check with your doctor before starting her on cow's milk. Your doctor may recommend that you start with a soy beverage that's been fortified with vitamin D and calcium. (See what our experts say about giving soy milk or rice milk to a child who won't drink cow's milk.)
The main symptoms of milk allergy are blood in the stool, diarrhea, and vomiting. If your child also develops eczema, hives, a rash around the mouth and chin, chronic nasal stuffiness, a runny nose, cough, wheezing, or breathing difficulties, it could be a sign that the respiratory system is being affected by a milk allergy. If your toddler develops any of these symptoms, talk with her doctor.
If your child appears to have sudden and severe problems with breathing or swallowing, take her to the nearest emergency room. She may be having a life-threatening allergic reaction.
If it turns out that your toddler is allergic to cow's milk, you'll want to be careful to avoid foods such as cottage cheese, condensed or evaporated milk, ice cream, yogurt, margarine that contains milk, butter, milk chocolate, and powdered milk. Thanks to a law passed in 2004, all allergens must be clearly marked on food products – in this case, the label will say "milk."
Note: This article was reviewed by Nancy Hudson, M.S., R.D., a nutrition educator at the University of California at Davis.

Lung Cancer Isn't The Only Smoking-Related Cancer; There Are 12 Others

12 Smoking-Related Cancers Contribute To Over 150,000 Deaths From Cigarette Smoking

Smoking prevalence has declined dramatically since the first U.S. Surgeon General’s Report on Smoking and Health in 1964. However, more than 20 percent of men and more than 15 percent of women in the United States still smoke. A recent study published in JAMA Internal Medicine has found that 48.5 percent of around 346,000 deaths attributed to 12 types of cancer are caused by cigarette smoke.
 
"Cigarette smoking continues to cause numerous deaths from multiple cancers despite half a century of decreasing prevalence," authors of the study said in a statement. "Continued progress in reducing cancer mortality, as well as deaths from many other serious diseases, will require more comprehensive tobacco control, including targeted cessation support."
Lead researcher from the American Cancer Society, Dr. Rebecca L. Siegel, and her colleagues combed through data from the 2011 National Health Interview Survey and the Cancer Prevention Study III. The research team set out to provide an updated estimate for the number of smoking-related cancer deaths due to recent changes in smoking prevalence and deaths attributed to cancer. They did recognize some of the study’s limitations, which included the study’s population being less diverse and more education than the U.S. population and exposure to tobacco products other than cigarettes.
Among the 345,962 cancer-related deaths, 167,805 were attributed to smoking cigarettes. The majority of these deaths were attributed to cancer of the lung, bronchus, and trachea (which accounted 125,799 deaths) and cancers of the larynx (which accounted for 2,856 deaths). Half of all deaths tied to cancers of the oral cavity, esophagus, and urinary bladder were also the result of smoking. Although smoking prevalence dropped from 23.2 percent in 2000 to 18.1 percent in 2012, a person’s risk for a smoking-related cancer death can increase over time.
According to the American Cancer Society, lung cancer is the leading cause of cancer death in the U.S. among both men and women, but it’s also considered the most preventable form of cancer death in the world. Tobacco use is attributed to around one out of every five deaths, or 480,000 premature deaths each year. In addition to lung cancer, tobacco use can increase our risk for cancers of the lips, nose and sinuses, larynx, pharynx, esophagus, stomach, pancreas, kidney, bladder, uterus, cervix, colon/rectum, ovary, and acute myeloid leukemia.
Source: Jacobs E, Newton C, Siegel R, et al. Deaths Due to Cigarette Smoking for 12 Smoking-Related Cancers in the United States. JAMA Internal Medicine. 2015.

7 Health Benefits Of Drinking Alcohol

Getting wasted every weekend might not be the best thing for your physical or mental well-being, but moderate alcohol consumption may have some substantial health benefits. It should be noted that alcohol consumption and its benefits vary based on an individual's body makeup and type.
According to the Dietary Guidelines for Americans, "moderate alcohol consumption is defined as having up to one drink per day for women and up to two drinks per day for men. This definition is referring to the amount consumed on any single day and is not intended as an average over several days."
Now, we've all heard the reasons why alcohol is bad for you, but what about the benefits? Here is our list of seven ways that drinking alcohol in moderation (when you're of the legal drinking age of course) might benefit your health.

1. It Can Lower Your Risk Of Cardiovascular Disease

The School of Public Health at Harvard University found that "moderate amounts of alcohol raises levels of high-density lipoprotein, HDL, or 'good' cholesterol and higher HDL levels are associated with greater protection against heart disease. Moderate alcohol consumption has also been linked with beneficial changes ranging from better sensitivity to insulin to improvements in factors that influence blood clotting....Such changes would tend to prevent the formation of small blood clots that can block arteries in the heart, neck, and brain, the ultimate cause of many heart attacks and the most common kind of stroke." This finding is applicable to both men and women who have not been previously diagnosed with any type of cardiovascular disease.

2. It Can Lengthen Your Life

Drinking occasionally could add a few years to your life. A study by the Catholic University of Campobasso reported that drinking less than four or two drinks per day for men and women respectively could reduce the risk of death by 18 percent, as reported by Reuters. "Little amounts, preferably during meals, this appears to be the right way (to drink alcohol)," said Dr. Giovanni de Gaetano of Catholic University, another author on the study. "This is another feature of the Mediterranean diet, where alcohol, wine above all, is the ideal partner of a dinner or lunch, but that's all: the rest of the day must be absolutely alcohol-free."

3. It Can Improve Your Libido

Contrary to prior beliefs, newer research has found that moderate drinking might actually protect against erectile dysfunction in the same way that drinking red wine might benefit heart disease. In a 2009 study published in the, Journal of Sexual Medicine, researchers found that the chances of erectile dysfunction were reduced by 25 to 30 percent among alcohol drinkers. The lead researcher, Kew-Kim Chew, an epidemiologist at the University of West Australia, conducted the study with 1,770 Australian men. In his study, Chew cautiously noted that he and his team in no way are advising men to hit the bottle, and that further research is needed to accurately connect impotence and alcohol consumption.

4. It Helps Prevent Against the Common Cold

The Department of Psychology at Carnegie Mellon University found that while susceptibility to the common cold was increased by smoking, moderate alcohol consumption led to a decrease in common cold cases for nonsmokers. This study was conducted in 1993 with 391 adults. In 2002, according to the New York Times, Spanish researchers found that by drinking eight to 14 glasses of wine per week, particularly red wine, one could see a 60-percent reduction in the risk of developing a cold. The scientists suspected that this had something to do with the antioxidant properties of wine.

5. It Can Decrease Chances Of Developing Dementia

In a study that included more than 365,000 participants since 1977, as reported in the journal Neuropsychiatric Disease and Treatment, moderate drinkers were 23 percent less likely to develop cognitive impairment or Alzheimer's disease and other forms of dementia. "Small amounts of alcohol might, in effect, make brain cells more fit. Alcohol in moderate amounts stresses cells and thus toughens them up to cope with major stresses down the road that could cause dementia," said Edward J. Neafsey, Ph.D., co-author of the study, as reported by Science Daily. "We don't recommend that nondrinkers start drinking," Neafsey said. "But moderate drinking — if it is truly moderate — can be beneficial."

6. It Can Reduce The Risk Of Gallstones

Drinking two units of alcohol per day can reduce the risk of gallstones by one-third, according to researchers at the University of East Anglia. The study found that those who reported consuming two UK units of alcohol per day had a one-third reduction in their risk of developing gallstones. "Researchers emphasized that their findings show the benefits of moderate alcohol intake but stress that excessive alcohol intake can cause health problems," according to the study.

7. Lowers The Chance Of Diabetes

Results of a Dutch study showed that healthy adults who drink one to two glasses per day have a decreased chance of developing type 2 diabetes, in comparison to those who don't drink at all. "The results of the investigation show that moderate alcohol consumption can play a part in a healthy lifestyle to help reduce the risk of developing diabetes type 2," researchers said in a statement to Reuters.

Alcohol: Balancing Risks and Benefits

 
Table of Contents

• Introduction
• What’s Moderate Alcohol Intake? What’s a Drink?
• Possible Health Benefits of Alcohol
• The Dark Side of Alcohol
• Genes Play a Role
• Shifting Benefits and Risks
• The Bottom Line: Balancing Risks and Benefits

Introduction

Throughout the 10,000 or so years that humans have been drinking fermented beverages, they’ve also been arguing about their merits and demerits. The debate still simmers today, with a lively back-and-forth over whether alcohol is good for you or bad for you.
It’s safe to say that alcohol is both a tonic and a poison. The difference lies mostly in the dose. Moderate drinking seems to be good for the heart and circulatory system, and probably protects against type 2 diabetes and gallstones. Heavy drinking is a major cause of preventable death in most countries. In the U.S., alcohol is implicated in about half of fatal traffic accidents. (1) Heavy drinking can damage the liver and heart, harm an unborn child, increase the chances of developing breast and some other cancers, contribute to depression and violence, and interfere with relationships.
Alcohol’s two-faced nature shouldn’t come as a surprise. The active ingredient in alcoholic beverages, a simple molecule called ethanol, affects the body in many different ways. It directly influences the stomach, brain, heart, gallbladder, and liver. It affects levels of lipids (cholesterol and triglycerides) and insulin in the blood, as well as inflammation and coagulation. It also alters mood, concentration, and coordination.

What’s Moderate Alcohol Intake? What’s a Drink?

Loose use of the terms “moderate” and “a drink” has fueled some of the ongoing debate about alcohol’s impact on health.

The comparatively low rate of heart disease in France despite a diet that includes plenty of butter and cheese has become known as the French paradox.

Some experts have suggested that red wine makes the difference, but other research suggests that beverage choice appears to have little effect on cardiovascular benefit.

Learn more about whether the type of alcohol consumed has any effect on health.

In some studies, the term “moderate drinking” refers to less than one drink per day, while in others it means three or four drinks per day. Exactly what constitutes “a drink” is also fairly fluid. In fact, even among alcohol researchers, there’s no universally accepted standard drink definition. (2)
In the U.S., one drink is usually considered to be 12 ounces of beer, 5 ounces of wine, or 1½ ounces of spirits (hard liquor such as gin or whiskey). (3) Each delivers about 12 to 14 grams of alcohol.
The definition of moderate drinking is something of a balancing act. Moderate drinking sits at the point at which the health benefits of alcohol clearly outweigh the risks.
The latest consensus places this point at no more than one to two drinks per day for men, and no more than one drink per day for women. This is the definition used by the U.S. Department of Agriculture and the Dietary Guidelines for Americans, (3) and is widely used in the United States.

Possible Health Benefits of Alcohol

What are some of the possible health benefits associated with moderate alcohol consumption?

Cardiovascular Disease

More than 100 prospective studies show an inverse association between moderate drinking and risk of heart attack, ischemic (clot-caused) stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes. (4) The effect is fairly consistent, corresponding to a 25 percent to 40 percent reduction in risk.

Learn more about the results of some large prospective studies of alcohol consumption and cardiovascular disease.

The connection between moderate drinking and lower risk of cardiovascular disease has been observed in men and women. It applies to people who do not apparently have heart disease, and also to those at high risk for having a heart attack or stroke or dying of cardiovascular disease, including those with type 2 diabetes, (5, 6) high blood pressure, (7, 8) and existing cardiovascular disease. (7, 8) The benefits also extend to older individuals. (9)
The idea that moderate drinking protects against cardiovascular disease makes sense biologically and scientifically. Moderate amounts of alcohol raise levels of high-density lipoprotein (HDL, or “good” cholesterol), (10) and higher HDL levels are associated with greater protection against heart disease. Moderate alcohol consumption has also been linked with beneficial changes ranging from better sensitivity to insulin to improvements in factors that influence blood clotting, such as tissue type plasminogen activator, fibrinogen, clotting factor VII, and von Willebrand factor. (10) Such changes would tend to prevent the formation of small blood clots that can block arteries in the heart, neck, and brain, the ultimate cause of many heart attacks and the most common kind of stroke.

Does Alcohol Cause These Benefits?

People who drink in moderation are different from non-drinkers or heavy drinkers in ways that could influence health and disease.

Folate and Alcohol

Folate, the B vitamin that helps guide the development of an embryo’s spinal cord, has equally important jobs later in life. One of the biggest is helping to build DNA, the molecule that carries the code of life. In this way, folate is essential for accurate cell division.

Alcohol blocks the absorption of folate and inactivates folate in the blood and tissues. It’s possible that this interaction may be how alcohol consumption increases the risk of breast, colon, and other cancers.

Getting extra folate may cancel out this alcohol-related increase. In the Nurses’ Health Study, for example, among women who consumed one alcoholic drink a day or more, those who had the highest levels of this B vitamin in their blood were 90% less likely to develop breast cancer than those who had the lowest levels of the B vitamin. (28) An earlier study suggested that getting 600 micrograms a day of folate could counteract the effect of moderate alcohol consumption on breast cancer risk. (26)

Part of a national 1985 health interview survey showed that moderate drinkers were more likely than non-drinkers or heavy drinkers to be at a healthy weight, to get seven to eight hours of sleep a night, and to exercise regularly. (11) Researchers have statistically accounted for such confounders, and they do not come close to accounting for the relationship between alcohol and heart disease. This, plus the clearly beneficial effects of alcohol on cardiovascular risk factors, makes a compelling case that alcohol itself, when used in moderation, reduces the risk of cardiovascular disease.
The most definitive way to investigate the effect of alcohol on cardiovascular disease would be with a large trial in which some volunteers were randomly assigned to have one or more alcoholic drinks a day and others had drinks that looked, tasted, and smelled like alcohol but were actually alcohol free. Many of these trials have been conducted for weeks, and in a few cases months, to look at changes in the blood, but a long-term trial to test experimentally the effects of alcohol on cardiovascular disease over many years will probably never be done. Nevertheless, the connection between moderate drinking and cardiovascular disease almost certainly represents a cause-and-effect relationship.

Beyond the Heart

The benefits of moderate drinking aren’t limited to the heart. In the Nurses’ Health Study, the Health Professionals Follow-up Study, and other studies, gallstones (12, 13) and type 2 diabetes (5, 14, 15) were less likely to occur in moderate drinkers than in non-drinkers. The emphasis here, as elsewhere, is on moderate drinking. In a meta-analysis of 15 original prospective cohort studies that followed 369,862 participants for an average of 12 years, no benefit was observed for heavy drinkers who consumed more than 48 grams of alcohol (the equivalent of four drinks) a day. (5) The social and psychological benefits of alcohol can’t be ignored. A drink before a meal can improve digestion or offer a soothing respite at the end of a stressful day; the occasional drink with friends can be a social tonic. These physical and psychic effects may contribute to health and well-being.

Drinking Patterns Matter

What you drink (beer or wine) doesn’t seem to be nearly as important as how you drink. Having seven drinks on a Saturday night and then not drinking the rest of the week isn’t at all the equivalent of having one drink a day. The weekly total may be the same, but the health implications aren’t. Among participants in the Health Professionals Follow-up Study, consumption of alcohol on at least three or four days a week was inversely associated with the risk for myocardial infarction. The amount consumed, under 10 grams a day or more than 30 grams, didn’t seem to matter as much as the regularity of consumption. (16) A similar pattern was seen in Danish men. (17)

The Dark Side of Alcohol

If all drinkers limited themselves to a single drink a day, we probably wouldn’t need as many cardiologists, liver specialists, mental health professionals, and substance abuse counselors. But not everyone who likes to drink alcohol stops at just one. While most people drink in moderation, some don’t.
On the personal level, heavy drinking can take a toll on the body. It can cause inflammation of the liver (alcoholic hepatitis) and lead to scarring of the liver (cirrhosis), a potentially fatal disease. Heavy drinking can increase blood pressure and damage heart muscle (cardiomyopathy). It has also been linked with several cancers: The World Cancer Research Fund and American Institute for Cancer Research indicate that there is convincing evidence linking alcohol use to cancer of the mouth, pharynx, larynx, esophagus, breast, and colon and rectum in men, and probable evidence that its use contributes to liver cancer and colorectal cancer in women. (18) The risk is multiplied for drinkers who also smoke tobacco.
Problem drinking also touches drinkers’ families, friends, and communities. According to the National Institute on Alcohol Abuse and Alcoholism and others:

• 18.2 million Americans meet standard criteria for alcohol abuse or alcoholism. (19)
• Alcohol plays a role in one in three cases of violent crime. (20)
• More than 16,000 people die each year in automobile accidents in which alcohol is involved. (21)
• Alcohol abuse costs more than $185 billion dollars a year. (22)

Even moderate drinking carries some risks. Alcohol can disrupt sleep. Its ability to cloud judgment is legendary. Alcohol interacts in potentially dangerous ways with a variety of medications, including acetaminophen, antidepressants, anticonvulsants, painkillers, and sedatives. It is also addictive, especially for people with a family history of alcoholism.

Alcohol Increases Risk of Developing Breast Cancer

There is convincing evidence that alcohol consumption increases the risk of breast cancer. (23, 24) In a combined analysis of six large prospective studies involving more than 320,000 women, researchers found that having two or more drinks a day increased the chances of developing breast cancer as much as 41 percent. (23)
This doesn’t mean that 40 percent or so of women who have two drinks a day will get breast cancer. Instead, it is the difference between about 12.7 of every 100 women developing breast cancer during their lifetime—the current average risk in the US—and 17 to 18 of every 100 women developing the disease. This modest increase would translate to significantly more women with breast cancer each year.
Adequate daily intake of folate, at least 600 micrograms a day, appears to mitigate this increased risk. (25, 26) (Read more about folate and alcohol.)

Genes Play a Role

Twin, family, and adoption studies have firmly established that genetics plays an important role in determining an individual’s preferences for alcohol and his or her likelihood for developing alcoholism. Alcoholism doesn’t follow the simple rules of inheritance set out by Gregor Mendel. Instead, it is influenced by several genes that interact with each other and with environmental factors. (1)
There is also some evidence that genes influence how alcohol affects the cardiovascular system. An enzyme called alcohol dehydrogenase helps metabolize alcohol. One variant of this enzyme, called alcohol dehydrogenase type 1C (ADH1C), comes in two “flavors.” One quickly breaks down alcohol, the other does it more slowly. Moderate drinkers who have two copies of the gene for the slow-acting enzyme are at much lower risk for cardiovascular disease than moderate drinkers who have two genes for the fast-acting enzyme. (27) Those with one gene for the slow-acting enzyme and one for the faster enzyme fall in between.
It’s possible that the fast-acting enzyme breaks down alcohol before it can have a beneficial effect on HDL and clotting factors. Interestingly, these differences in the ADH1C gene do not influence the risk of heart disease among people who don’t drink alcohol. This adds strong indirect evidence that alcohol itself reduces heart disease risk.

Shifting Benefits and Risks

The benefits and risks of moderate drinking change over a lifetime. In general, risks exceed benefits until middle age, when cardiovascular disease begins to account for an increasingly large share of the burden of disease and death.

• For a pregnant woman and her unborn child, a recovering alcoholic, a person with liver disease, and people taking one or more medications that interact with alcohol, moderate drinking offers little benefit and substantial risks.
• For a 30-year-old man, the increased risk of alcohol-related accidents outweighs the possible heart-related benefits of moderate alcohol consumption.
• For a 60-year-old man, a drink a day may offer protection against heart disease that is likely to outweigh potential harm (assuming he isn’t prone to alcoholism).
• For a 60-year-old woman, the benefit/risk calculations are trickier. Ten times more women die each year from heart disease (460,000) than from breast cancer (41,000). However, studies show that women are far more afraid of developing breast cancer than heart disease, something that must be factored into the equation.

The Bottom Line: Balancing Risks and Benefits

Given the complexity of alcohol’s effects on the body and the complexity of the people who drink it, blanket recommendations about alcohol are out of the question. Because each of us has unique personal and family histories, alcohol offers each person a different spectrum of benefits and risks. Whether or not to drink alcohol, especially for “medicinal purposes,” requires careful balancing of these benefits and risks.
Your health-care provider should be able to help you do this. Your overall health and risks for alcohol-associated conditions should factor into the equation. If you are thin, physically active, don’t smoke, eat a healthy diet, and have no family history of heart disease, drinking alcohol won’t add much to decreasing your risk of cardiovascular disease.
If you don’t drink, there’s no need to start. You can get similar benefits with exercise (beginning to exercise if you don’t already or boosting the intensity and duration of your activity) or healthier eating. If you are a man with no history of alcoholism who is at moderate to high risk for heart disease, a daily alcoholic drink could reduce that risk. Moderate drinking might be especially beneficial if you have low HDL that just won’t budge upward with diet and exercise.
If you are a woman with no history of alcoholism who is at moderate to high risk for heart disease, the possible benefits of a daily drink must be balanced against the small increase in risk of breast cancer.
If you already drink alcohol or plan to begin, keep it moderate—no more than two drinks a day for men or one drink a day for women. And make sure you get plenty of folate, at least 600 micrograms a day.

References

1.10th Special Report to the U.S. Congress on Alcohol and Health. National Institute on Alcohol Abuse and Alcoholism.
2.Kloner RA, Rezkalla SH. To drink or not to drink? That is the question. Circulation. 2007; 116:1306–17.
3.Dietary guidelines for Americans 2005. U.S. Department of Agriculture.
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8.Muntwyler J, Hennekens CH, Buring JE, Gaziano JM. Mortality and light to moderate alcohol consumption after myocardial infarction. Lancet. 1998; 352:1882–85.
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12.Grodstein F, Colditz GA, Hunter DJ, Manson JE, Willett WC, Stampfer MJ. A prospective study of symptomatic gallstones in women: relation with oral contraceptives and other risk factors. Obstet Gynecol. 1994; 84:207–14.
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18.World Cancer Research Fund, American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. Washington, D.C.: AICR, 2007.
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21.Impaired driving. Centers for Disease Control and Prevention.
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28.Zhang SM, Willett WC, Selhub J, et al. Plasma folate, vitamin B6, vitamin B12, homocysteine, and risk of breast cancer. J Natl Cancer Inst. 2003; 95:373–80.

11 Facts about Chocolate

1. Dark chocolate has more cacao (the beans that chocolate are made from) and less sugar than other chocolates, so it is considered healthier than milk and white chocolate
2. Dark chocolate contains lots of antioxidants that help the cardiovascular system by reducing blood pressure
3. Eating dark chocolate widens arteries and promotes healthy blood flow that can prevent the buildup of plaque that can block arteries.
4. Eating dark chocolate every day reduces the risk of heart disease by 1/3.
5. Flavonoids found in cocoa products have antioxidant, anti-inflammatory, anti-clotting effects that can reduce the risk of diabetes by improving insulin sensitivity.

6. The smell of chocolate increases theta brain waves, which trigger relaxation.
7. Chocolate can cause headaches and is not recommended in large doses for people who suffer from migraines or chronic headaches.
8. Because chocolate contains high doses of caffeine and sugar, chocolate products are largely to blame for ADHD (Attention Deficit Hyperactivity Disorder) in children.
9. In the U.S., most consumer chocolate comes from cocoa farms. Unfortunately, many cocoa farms have unsafe working conditions, unfair labor wages, and child labor trafficking.
10. In 2010 1.8 million children ages 5 to 17 were forced laborers on cocoa farms across the Ivory Coast and Ghana 40% were not enrolled in school and only 5% of them were paid to work. UNICEF projects that 35,000 of these children are victims of trafficking.
11. Fair Trade Certified chocolate says that no forced abusive child labor is used, but Fair Trade chocolate represents less than 1 percent of the $66 billion chocolate market.

Cell Phone Use May Disrupt the Fetus

Cell Phone Use May Disrupt the Fetus

WEDNESDAY, May 6, 2015 (HealthDay News) -- The sounds emitted by cellphones carried by pregnant women may rattle the sleep-and-wake cycles of their fetuses, new research suggests.
The finding is based on a small study that tracked fetal reactions to repetitive cellphone and beeper use among more than two dozen resident physicians while they were pregnant.
"We wanted to see what these devices can do to the fetus," said study co-author Dr. Boris Petrikovsky, a professor of obstetrics and gynecology, and director of maternal and fetal medicine at Wyckoff Heights Medical Center in New York City.
"And actually what we figured out is that if you're a baby in-utero [in the womb] and someone wakes you up every hour, you will not be a happy camper. The sound, and perhaps even vibrations, cause a lot of 'startle reflex', which disturbs the normal sleep cycle," he said.
What isn't clear from this study is whether or not being repeatedly startled has any effect on fetal health or pregnancy outcomes.
Previous research has suggested that pregnant women who are resident physicians tend to have a higher-than-average rate of pregnancy complications, including premature birth, excessively high blood pressure (pre-eclampsia) and low birth weight. Because of the nature of their duties, such medical residents often carry phones and beepers close to their body, over very thin medical scrubs, for long periods of time.
"We can't say that this is definitely causing the higher pregnancy risk that has been seen," Petrikovsky added. "But we can say for sure that cycles of normal fetal behavior are definitely disturbed or interrupted by the frequent use of cellphones and beepers."
Petrikovsky and his co-author, Dr. Evgeny Zharov, are expected to present their research this week at a meeting of the American Congress of Obstetricians and Gynecologists in San Francisco. Findings presented at meetings are generally considered preliminary until they've been published in a peer-reviewed journal.
The research team pointed out that 80 percent of obstetrics and gynecology residents are women. And many such residents perform their jobs while pregnant.
The study included 28 obstetrics and gynecology residents, all of whom were in their third trimester.
All carried beepers or cellphones in a position near the fetus' head, and on five occasions the devices were activated to emit a series of rings separated by five-minute intervals. The women underwent ultrasound screening during this time so the researchers could assess the effect on the fetuses.
All of the fetuses (who were between 27 and 41 weeks of gestation) displayed startle response when exposed to a single generated sound. Responses included head-turning, mouth-opening or blinking, the study authors said.
When devices were triggered to repeatedly ring every 10 minutes, 90 percent of the fetuses exhibited a similar startle response on the first occasion. Eighty percent of the fetuses continued to do so during subsequent rings, the findings showed.
However, the researchers found that many of the fetuses appeared to essentially get used to the sounds. When phones and beepers were made to ring repeatedly every five minutes, the researchers observed a drop in startle reactions among more than 60 percent of the fetuses under 36 weeks' gestation and among 90 percent of full-term fetuses.
Still, the researchers concluded that repeated exposure to the sounds of such devices, when carried near the fetal head, may get in the way of normal fetal behavior.
"Of course there are other factors that could contribute to a fetus being startled," Petrikovsky acknowledged. "But it has previously been reported that pregnant women who reside in proximity to major airports, with planes constantly landing and taking off, also experience problems like this. So we know that noise, and especially repeated noise, can affect the baby," he said.
"So we now recommend that women not carry cellphones and beepers in close proximity to their baby," Petrikovsky added. "They should put it in their chest pocket or bag. The further away it is from the baby, the less chance the baby will be affected."
Dr. Tomer Singer, an obstetrician and gynecologist at North Shore-LIJ Center for Human Reproduction in New York, described the findings as "very interesting."
At the same time, Singer cautioned that "the study is very small and has no control group. Therefore, the authors' conclusion should be taken with a grain of salt, as a much larger randomized prospective study is required in order to investigate and draw conclusions."
SOURCES: Boris M. Petrikovsky, M.D., Ph.D., professor, obstetrics and gynecology, and director, maternal and fetal medicine, Wyckoff Heights Medical Center, New York City; Tomer Singer, M.D., obstetrician/gynecologist, and director, egg freezing program, North Shore-LIJ, and program director, department of obstetrics and gynecology, Lenox Hill Hospital, New York City; American Congress of Obstetricians and Gynecologists meeting, San Francisco, May 2-6, 2015

Urinary Tract Infections (UTI)

Urinary Tract Infections

Overview

Most urinary tract infections are caused by a variety of bacteria, including Escherichia coli (E. coli), found in feces. Because the openings of the bowel, vagina and urethra are close together, it's easy for the bacteria to spread to the urethra and travel up the urinary tract into the bladder and sometimes the kidneys.
 
What Is It?
Urinary tract infections result in eight to 10 million doctors' office visits each year in the United States, and at least 50 percent of women will have at least one urinary tract infection at some point in their lives.
Luckily, most urinary tract infections are not serious and can be easily treated with antibiotic medications. The symptoms of a urinary tract infection can be stubborn and can persist after treatment. Sometimes an infection recurs a few weeks after treatment. Nearly 20 percent of women who have a urinary tract infection will have another, and 30 percent of those who have had two will have a third. About 80 percent of those who have had three will have a fourth. If left untreated, urinary tract infections can lead to other more complicated health problems so they should not be ignored.
How the Urinary Tract Works
Your urinary tract includes two kidneys, two ureters, the bladder and the urethra. Your kidneys remove waste and water from your blood to produce urine. Urine travels through muscular tubes, called the ureters, to the bladder. The bladder is a balloon-like organ composed of muscle, connective tissue and nerves that swells as it fills with urine. Urine is stored in the bladder until it is released from the body through another tube, called the urethra. Two muscle groups, the pelvic floor muscles and the urinary sphincters, control the activity of the urethra and bladder neck. These muscles must work together to hold urine in the bladder most of the time and allow the bladder to empty when appropriate.
Cause of Urinary Tract Infection: Bacteria
Most urinary tract infections are caused by a variety of bacteria, including Escherichia coli (E. coli), found in feces. Because the openings of the bowel, vagina and urethra are very close together, it's easy for the bacteria to spread to the urethra and travel up the urinary tract into the bladder and sometimes up to the kidneys.
Untreated Urinary Tract Infections: Bladder & Kidney Infections
Infection occurs when the bacteria cling to the opening of the urethra and multiply, producing an infection of the urethra, called urethritis. The bacteria often spread up to the bladder, causing a bladder infection, called cystitis. Untreated, the infection can continue spreading up the urinary tract, causing infection in the kidneys, called pyelonephritis. Pyelonephritis can also occur without a preceding bladder infection.
A kidney infection that is not treated can result in the bacteria entering the bloodstream (this is known as urosepsis), which can be a life-threatening infection requiring hospitalization and intravenous antibiotics.
The first sign of a bladder infection may be a strong urge to urinate or a painful burning sensation when you urinate. You may feel the urge to go frequently, with little urine eliminated each time. At times, the urge to urinate may be hard to control and you may have urinary leakage. You may also have soreness in your lower abdomen, in your back or in the sides of your body. Your urine may look cloudy or have a reddish tinge from blood. It may smell foul or strong. You also may feel tired, shaky and washed out.
If the infection has spread to the kidneys, you may have fever, chills, nausea, vomiting and back pain, in addition to the frequent urge to urinate and painful urination.
Common Causes of UTIs
Some women are more prone to urinary tract infections than others because the cells in their vaginal areas and in their urethras are more easily invaded by bacteria. Women with mothers or sisters who have recurring urinary tract infections also tend to be more susceptible. Your risk of urinary tract infection also is greater if you're past menopause. Thinning of the tissues of the vagina, bladder and urethra, as well as change in the vaginal environment after menopause, may make these areas less resistant to bacteria and cause more frequent urinary tract infections.
Irritation or injury to the vagina or urethra caused by sexual intercourse, douching, tampons or feminine deodorants can give bacteria a chance to invade. Using a diaphragm can cause irritation and can interfere with the bladder's ability to empty, giving bacteria a place to grow.
Any abnormality of the urinary tract that blocks the flow of urine, such as a kidney stone or significant prolapse of the uterus or vagina, also can lead to an infection or recurrent infections. Illnesses that affect the immune system, such as diabetes, AIDS and chronic kidney diseases, increase the risk of urinary tract infections. A weak bladder can also make it difficult to empty completely, allowing bacteria to grow. Lengthy use of an indwelling catheter, a soft tube inserted through the urethra into the bladder to drain urine, is a common source of urinary tract infections. Intermittent catheterization (where a person empties the bladder several times a day but the catheter is removed immediately) actually is used to prevent recurrent infections in some patients.
Because the uterus sits directly on the bladder during pregnancy and can block the drainage of urine from the bladder, UTIs are more common in pregnant women. And when women develop urinary tract infections during pregnancy, the bacteria are more likely to affect the kidneys. Hormonal changes and repositioning of the urinary tract during pregnancy may make it easier for bacteria to invade the kidneys. Such infections in pregnant women can lead to urosepsis, kidney damage, high blood pressure and premature delivery of the baby. All pregnant women should have their urine tested periodically during pregnancy. Pregnant women with a history of frequent urinary tract infections should have their urine tested often.
Most antibiotic medications are safe to take during pregnancy, but your health care professional will consider the drug's effectiveness, how far your pregnancy has progressed and the potential side effects on the fetus when determining which medication is right for you and how long you should take it.
Diagnosis
Your health care professional will determine whether you have a urinary tract infection based on your symptoms, a physical examination and the result of a laboratory test of your urine. You will be asked to urinate into a small cup. The urine will be examined under a microscope for bacteria and for a large amount of white blood cells, which fight infection. A urine culture may be done in which the bacteria in the urine are encouraged to grow. The bacteria can then be identified and may be tested to see which antibiotic best kills them.
If you are having recurrent symptoms of infections despite treatment, it is important that your urine be cultured before you are placed on antibiotics. Repeated treatment of presumed infections without urine culture should be avoided.
Some bacteria, such as chlamydia, can only be found with special urine cultures. A health care professional may suspect these infections when a woman has urinary tract infection symptoms, but a standard culture doesn't grow the bacteria.
If you have recurring urinary tract infections, your health care professional may suggest other tests to look for obstructions or other problems that might trap urine in the tract and cause infection:

• Intravenous pyelogram (IVP) is an X-ray exam of the urinary tract using a dye that is injected into a vein and then enters the kidneys, ureters and bladder. This test is not commonly used alone anymore.
  
• A computed tomography scan (CT scan), also known as a CT urography, is a type of X-ray test used to capture images of different structures in the body. The CT scan is usually given with an intravenous dye similar to that used in an IVP (see above). The dye allows your doctor to better see your kidneys, ureters and bladder. Newer CT scanners use much less radiation.
  
• Ultrasound uses sound waves to produce images of the urinary tract. No radiation is involved in this test.
• Cystoscopy is a test using a thin telescope-like instrument that allows your health care professional to see inside the urethra and bladder and examine them for problems.
  
  
  Treatment
  Urinary tract infections are treated with medications that kill the bacteria causing the infection. Your health care professional will determine which medication to prescribe and how you should take it, based on your medical history and condition and the results of the urine tests. Many medications can have side effects, so talk to your health care professional about what to expect. Also, medications can interact with other prescriptions and over-the-counter drugs, so make sure you tell your health care professional what drugs you are taking.
  The antibiotics most often used to treat urinary tract infection are pills typically taken for three days. More complicated infections are usually treated with seven to 10 days or more of antibiotics, depending on the bacteria causing the infection, the drug used and your medical history. The most frequently prescribed drugs include:
• ciprofloxacin (Cipro)
• levofloxacin (Levaquin)
• nitrofurantoin (Macrobid, Furadantin)
• norfloxacin (Noroxin)
• fosfomycin (Monurol)
  
• trimethoprim/sulfamethoxazole (Bactrim, Septra)
  

Note: Fluoroquinolones, which include the antibiotics ciprofloxacin, gatifloxacin, levofloxacin and norfloxacin, have been associated with an increased risk of tendonitis and tendon rupture. If you are prescribed one of these medications for a urinary tract infection, discuss this risk with your health care professional.
Urinary tract infections caused by microorganisms, such as chlamydia, may be treated with the antibiotics azithromycin, tetracycline or doxycycline.
Although your symptoms may be relieved in a day or two after starting the medication, you must take all the medication your health care professional prescribes. Otherwise, you run the risk of a recurrence. That is, some bacteria may survive and cause your infection to return or cause reinfection with a new or different organism.
To help ease your discomfort until the antibiotics kick in, you can take a prescription medication called phenazopyridine (Pyridium). A similar medication, called Uristat, is available over the counter. However, keep in mind that these medications only ease symptoms; they do not treat the infection. They also change the color of your urine, can interfere with laboratory testing and shouldn't be taken for more than 48 hours unless told differently by your health care provider.
If you are menopausal, you may experience more frequent urinary tract infections because thinning of the tissues of the vagina and urethra following menopause may make these areas less resistant to bacteria. Hormone replacement (either systemic or vaginal) may help. Vaginal estrogen has fewer health risks than systemic estrogen (such as in birth control pill and patches) because only a small amount is absorbed into the bloodstream. Vaginal estrogen is available as a cream (Estrace), a tablet (Vagifem, Premarin) and a flexible plastic ring (Estring). Femring is another vaginal estrogen product, but it has higher doses of estrogen and is primarily recommended for hot flashes; women with a uterus who use Femring should take progestin to minimize their risk of uterine cancer.
Discuss these treatment options and the latest research about their risks and benefits with your health care professional, keeping your personal health history and needs in mind. If you decide to take hormone replacement therapy, you should take the lowest dose that helps for the shortest time possible. You and your doctor should also reevaluate every six months whether or not you should be taking hormones.
Severe kidney infections may require hospitalization and treatment with intravenous antibiotics, especially if nausea, vomiting and fever increase the risk of dehydration and prevent the ability to swallow pills. Kidney infections usually require two weeks of antibiotic therapy, although treatment may extend as long as six weeks (this extended course usually is prescribed for men whose infections are due to prostatitis, however).
In addition to taking your medication, your health care professional may recommend drinking plenty of fluid (the equivalent of six to eight 8-ounce glasses a day) to help flush the urinary tract and avoiding foods and beverages that can irritate the urinary tract, such as coffee and alcohol. A heating pad may help to temporarily relieve pain.
After you've completed your course of medication, your health care professional may suggest a follow-up urine test to make sure the infection is gone.
Prevention
There are several simple, do-it-yourself techniques that may prevent a urinary tract infection. Some may work some of the time or only in some women. But, because they carry no side effects, they certainly are worth trying to prevent the often painful and bothersome symptoms the infection can bring:

• Drink plenty of fluid––the equivalent of six to eight 8-ounce glasses––every day to flush bacteria out of your urinary system. Water is the ideal fluid because it is readily available, inexpensive and noncaloric, but other beverages also count toward your fluid intake, including juices, milk and herbal teas. Even alcoholic beverages such as beer and wine and caffeinated beverages such as coffee and colas help replenish your fluids, but don't rely heavily on them because they have diuretic properties. Additionally, alcohol and caffeine, as well as spicy foods, are among the substances that may irritate the bladder and, thus, should be avoided.
• Make sure you're getting vitamin C in your diet, either through diet or supplements. Vitamin C, or ascorbic acid, makes your urine acidic, which discourages the growth of bacteria. Drinking cranberry juice may also produce the same effect. Cranberry supplements are a more concentrated form of cranberry juice without the sugar content.
• Urinate frequently and when you feel the urge; don't hold it in. Keeping urine in your bladder for long periods gives bacteria a place to grow.
• Avoid using feminine hygiene sprays and scented douches. They may irritate the urethra.
• If you wear a pad for urinary leakage, you should change it often. Wet pads provide an environment for bacteria to grow.

If you suffer from urinary tract infections more than three times a year, your health care professional may suggest one of the following therapies to try to prevent another recurrence:

• a low dosage of an antibiotic medication such as trimethoprim/sulfamethoxazole or nitrofurantoin, taken daily for six months or longer
• a single dose of an antibiotic medication taken after sexual intercourse if it is determined that your UTIs are related to sex
• a short, one- or two-day course of antibiotic medication taken when symptoms appear
  
• Use of preventive medications that change the bladder environment, such as methanamine.

If you experience recurring UTIs, home urine tests, which involve dipping a test stick into a urine sample, may be helpful.
Some research suggests that a woman's blood type may play a role in her risk of recurrent UTIs. Bacteria may be able to attach to cells in the urinary tract more easily in those with certain blood factors. Additional research will determine if such an association exists and whether it could be useful in identifying people at risk of developing recurrent UTIs.
Vaccines are being developed to help patients build up their own natural infection-fighting powers. Vaccines that are prepared using dead bacteria do not spread like an infection; instead, they prompt the body to produce antibodies that can later fight live organisms. Researchers are currently looking into vaccines that can be administered orally, by way of a vaginal suppository and through the nose.


Facts to Know

1. Urinary tract infections result in eight to 10 million doctors' office visits each year in the United States, and at least 50 percent of women will have at least one urinary tract infection at some point in their lives.
   
2. Nearly 20 percent of women who have one urinary tract infection will have another, and 30 percent of those who have had two will have a third. About 80 percent of those who have had three will have a fourth. Four out of five such women get another infection within 18 months of the last one.
3. Some women are more prone to the infection than others. Women at higher risk include those who are past menopause, who have diabetes or who use a diaphragm. If your mother or sister had frequent urinary tract infections, you are more likely to have one. Recently, researchers found that women who use spermicides as contraception—particularly if they use them with diaphragms—are also at a greater risk for recurrent UTIs.
   
4. About 2 percent to 7 percent of pregnant women develop a urinary tract infection. Pregnant women are more likely to have UTIs and the infection is more likely to spread to the kidneys. UTIs during pregnancy need prompt attention by a health care professional to avoid a premature birth. Pregnant women may have no symptoms associated with an infection so regular urine tests are important.
5. One type of bacteria––Escherichia coli (E. coli), which lives in the digestive system and spreads to the urinary tract––causes most urinary tract infections.
6. Urinaryurgency, urge incontinence and pain with urination can be early symptoms of urinary tract infection. Urinary urgency is characterized by frequent overwhelming urges to urinate. Urgency incontinence is urine leakage resulting from not getting to a toilet in time.
   
7. Urinary tract infections usually are not serious and are easily treated by taking antibiotics. Kidney infection is the most common complication and can produce fever, chills, nausea, vomiting and back pain.
8. Although urinary tract infections do occur in men, women are at greater risk because of their anatomy. The female urethra is short, and the rectum, vagina and urethra are located closely together in women, making it easy to spread bacteria that live in the digestive tract to the urinary tract.
9. Women who have more than three urinary tract infections in a year may benefit from preventive antibiotic therapy. Such therapy may involve taking a low dose of medication every day for six months or longer, taking a single dose after having sex or taking a dose for one or two days when symptoms begin to appear. If you experience recurring UTIs, home urine tests, which involve dipping a test stick into a urine sample, may be helpful.
10. When being treated for a urinary tract infection, take all the antibiotic medication you have been given, even if your symptoms are gone before you finish your prescription. If you fail to complete the treatment, the infection may still be present, and your symptoms will return or another infection may arise in a short time.

Bikini Wax Warning

Bikini Wax Warning

For some women, getting a bikini wax is no more nerve-racking than picking out toothpaste, while others have intense reservations about this personal, sometimes painful procedure. Regardless of your attitude walking into the salon, it's important to be aware of the things around you that could raise red flags regarding the facility's cleanliness.
A traditional bikini wax involves using warm wax to remove hair around the pubic region, traditionally along the thighs and below the bellybutton, in areas where hair might show if you're wearing a bikini.
In addition to removing pubic hair so it won't show in a bikini, some people choose to remove it for aesthetic, cultural, fashion, hygiene or other reasons. Waxing is typically done by a cosmetologist in a salon, but home kits are available.
If you've never gotten a bikini wax, it's good to decide ahead of time what you want. There are many styles of waxing, ranging from the bikini line to the Brazilian, sometimes called the Sphinx or Hollywood, which involves removal of all hair from the pubic region.
Getting a bikini wax—particularly a Brazilian wax—by a professional who doesn't practice safety and hygiene precautions may result in a rash, burns, ingrown hairs, or even a serious infection. You may avoid these primping pitfalls by keeping an eye out for signs that a salon runs a clean—or not-so-clean—operation.
At the front desk
You can learn a lot about a salon just by walking in the door. First, take a look around at their products and waiting area. Are shampoo bottles dusty? Are magazines and empty glasses strewn about the lobby? These could be indicators that things behind the scenes also need some tightening up.
Good signs include a friendly, informative receptionist who asks you to fill out a new client questionnaire that inquires about any sensitivities, allergies or other health issues, as well as a neat and tidy product display.
In the waxing room
Once you meet the professional who will be doing your bikini wax, be sure to ask her any questions you may have before the procedure, including potential side effects and after-wax skin care. When doing this, gauge her knowledge and don't be afraid to back out if she can't answer your inquiries, particularly if they pertain to her certification or licensure. It's better to risk offending someone than to end up with an uncomfortable rash or infection. After all, this is a very personal area you're letting her tend to.
Additionally, take a look around the room. All equipment should appear clean, organized and reasonably new. There should be a clean paper sheet on the table, and all sticks, strips and other disposable supplies should be in sealed containers.
During the procedure
Your waxing professional should wear gloves and should never, ever double dip. Double dipping is when a cosmetologist keeps dipping the same spatula or applicator into the tub of warm wax, then reheats that wax for the next client’s procedure. She should either use a new disposable spatuala each time she dips or use a palette on which she pours enough wax for your individual treatment.
If the technician uses a wax roller, the roller head should be a new disposable roller. If it’s not, ask if it was sanitized between clients. There should be no hair on the roller or other tools or surroundings before your procedure begins.
If you're getting a full-on Brazilian wax, you probably won't be offered disposable panties to wear during the procedure. Otherwise, feel free to ask for a pair if it makes you more comfortable.
After the waxing
Avoid any potential skin irritants for 24 hours after waxing. These can include hot temperatures from showers, tanning or hot tubs, as well as perfumed soaps, deodorants or sprays on the area where skin was removed.