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Mom with Type 1 diabetes delivers healthy baby girl

Pregnant with her third child, Carly Gahler, RN, BSN, a diabetes educator at Welia Health, saw the pandemic preparation unfold in her weekly prenatal appointments.

One week, clinic staff were wearing face masks. The next week they were donning face shields. And the next, scrubs and gowns. Guidelines for personal protective equipment (PPE) were changing as rapidly as new information about the virus arose and availability shifted. Carly had been working from home, so her prenatal appointments gave her a window into Welia Health’s COVID-19 response as a patient.

“I have Type 1 diabetes, which requires a little extra care for mom and baby. Starting at 32 weeks, which for me was early on in March, I was in the clinic twice a week for various appointments, just as everything was starting with COVID. Even though everyone was in masks, and you could only see their eyes, I could feel the warmth and love from the Welia Health team.”

Carly Gahler, Welia Health Diabetes Educator and recent Birthing Center Patient

Diabetes and pregnancy

Although Welia Health was increasing the use of virtual visits, Carly had to physically go to the clinic for her appointments. When pregnant women have Type 1 diabetes, they must complete a weekly biophysical profile starting at 32 weeks. This assessment checks four main categories of the baby’s health – heart rate, fluid level, tone and movement.

While there is a list of complications that can arise with diabetes in pregnancy, the two main concerns are hypoglycemia, a condition where blood sugar can drop to be dangerously low, and larger than average birth weight. Another concern for expectant mothers with diabetes is that continued high blood sugars can cause an increase in amniotic fluid, much more than they need. So, every four weeks, providers recommend a growth ultrasound to make sure the baby doesn’t grow too large or too rapidly. Throughout the pregnancy, both Carly’s and her baby’s assessments came back fine.

A new way of working

In her role as a diabetes educator, Carly focuses on these biophysical assessments when working with expectant mothers with Type 1, 2 and gestational diabetes. She closely monitors her patients, doing everything possible to keep moms and babies safe.

Due to the COVID-19 pandemic, any high-risk employees were asked to work from home to reduce their exposure. “I worked up until the Friday before the Monday I had my baby. The ability to work from home when you’re pregnant is wonderful – you don’t have to worry about which clothes fit at nine months,” Carly chuckled. “I was fortunate that most of my job duties were able to be done from a home office.”

Scheduled C-section

Carly’s first two pregnancies resulted in emergency c-sections, so with a scheduled c-section she liked having the chance to prepare a little more for her baby’s birth. Plus, the Governor’s Stay-at-Home orders during the pandemic allowed her plenty of time to make sure all the preparations were made. She even made sure her husband Traver’s bag was packed because new hospital rules did not allow him to leave and reenter.

Delivery among friends

Baby Madelyn Gahler, born June 15, 2020

“A planned c-section was a completely different – and much improved – delivery experience than with my previous emergency c-sections,” commented Carly.

Dr. Matthew Schultz delivered Carly’s healthy baby girl, Madelyn, on June 15 at 8:05 am. She weighed 8 pounds and 9 ounces.

“Having my baby at Welia Health was just a wonderful experience,” said Carly. “Given COVID, we couldn’t have visitors, but knowing all of the staff, many quickly stopped by to say hello and wish us well. I could literally feel the compassion from the nurses because they just take such great care of their patients.”

Madelyn was born in the new birthing center. Carly remarked that the rooms are beautiful with large windows allowing in a ton of natural light. She loved having her husband and baby in the room with her.

“Other than a few hints of change and encouraged masking, there wasn’t anything major that made delivering during a pandemic too different,” said Carly. “The whole process was quite comforting. In fact, not having visitors was nice in a way because Traver and I had that time to focus on my recovery and just bond with Madelyn.”

Adjusting to a zone defense

Madelyn has two big adoring brothers, Mason who is six, and Milo who is three. When Carly, Traver and Madelyn were in the hospital, they FaceTimed with the boys, yet only talked for a bit because they were off running and playing. But now that everyone is home and adjusting, it is much different.

“Mason and Milo are just enamored with Madelyn and love her to pieces,” said Carly. “Milo is normally our wild one, always wrestling with his big brother. But now has been so gentle with his little sister, holding her and even singing to her. It’s like a switch flipped in him and he has become a protector and caregiver. Mason is just excited to be a big brother again.”

Carly also has enjoyed seeing Traver be a father to a daughter. Her husband loves to wrestle with the boys, but she is finding his tone with Madelyn so sweet. Carly feels a different vibe when she watches Traver cuddling with his daughter or when he’s simply holding her. She’s enjoying the nuance.

The new parents of three are a little intimidated by being outnumbered. With family close by, Carly is thankful for the help and support she can count on. Having three kids will be a big change, but it’s one Carly and Traver are ready for, particularly as they watch their boys with their baby sister.

Most details of a birthing experience are forgotten in a few years, but Carly will remember this experience as one in a lifetime – giving birth during a pandemic, now being outnumbered, and adjusting to a whole new normal.


Welia Health continues literacy initiative

A book is just the beginning of a bright future. The ability to read well and to enjoy reading is critical for a child’s later success. Reading for pleasure correlates with academic achievement and the opportunity for career growth, well beyond the elementary school years.

Third grade is a pivotal year for reading development. “Around third grade, the average reader is doing more than merely reading the words on the pages. They begin to use comprehension skills to ask if the words make sense and use their own personal experiences to understand and relate to the stories and conversations they are having (Scholastic.com).”

Third grade is also crucial because it is the final year that children are learning to read—by fourth grade, students are reading to learn. Students who are not proficient readers at the start of fourth grade will struggle to learn and fall further behind. In fact, a long-term study called Early Warning! Why Reading by the End of Third Grade Matters showed that students who were not proficient in reading by the end of third grade were four times more likely to drop out of high school than proficient readers. What’s more, 88 percent of students who have failed to earn a high school diploma were struggling readers in third grade.

Welia Health promotes reading

Reach Out & Read Minnesota Logo
Welia Health is a proud partner of Reach Out & Read Minnesota, offering books to our pediatric patients.

Given the importance of learning to read, particularly in third grade, Welia Health speech therapists Liz Eklund, Bethany Werner, Amy Miller and Julie Rue volunteered to read to area third graders just last month. They visited Hinckley, Pine City, Mora and Finlayson Elementary Schools to read the first chapter of one of three books: Secrets According to Humphrey and School Days According to Humphrey, both by Betty G. Birney, and Very Short Fairy Tales to Read Together by Mary Ann Hoberman. The kids then got to take the book home to keep and finish reading on their own.

The campaign extends Welia Health’s work with Reach Out and Read Minnesota. The Reach Out and Read model incorporates books into pediatric well-child visits, starting at six months and continuing through age five. Through the program, Welia Health providers use age-appropriate books as a tool to gauge a child’s development and to encourage parents to read to their children.

Research shows that the Reach Out and Read program promotes literacy, and Welia Health is a proud partner by offering books to our pediatric patients. According to a National Institute of Health study, “This simple and inexpensive intervention, delivered as part of well-child care, changed parent attitudes toward the importance of reading with their infants and toddlers. Through these interventions, parents and their children read more together, and this in turn was associated with enhanced language development in older toddlers in a diverse group of families.”

Importance of reading to babies and toddlers

When you read, talk, sing and play with babies and toddlers, the brain forms strong neural connections or synapses that create the foundation for all future learning, behavior and health. While brains are built over time, the foundations of brain architecture are constructed early in life. In fact, 80 percent of a child’s brain develops by age three.

Father reading bedtime stories to child.

Many parents don’t realize that moments of connection through talking, reading, singing, and playing, particularly in the first 90 days, have a tremendous and lasting impact given how the brain develops. When parents do know the impact, behaviors change.

That’s why Welia Health is committed to the Reach Out and Read program. Parents who participate in Reach Out and Read are 2.5 times more likely to read with their children. And when you read to young children, good things happen beyond creating healthy together time for parents and children. The lifelong benefits include:

  • Increased vocabulary, curiosity and memory
  • Positive associations with books and reading
  • Opportunities to build listening skills
  • A foundation for scholastic success

While reading books to infants and toddlers is critical to language and brain development, reading the signs in the grocery store while you’re shopping or in the waiting room before your doctor’s appointment is helpful, too. In fact, there’s a new statewide movement in Minnesota called Little Moments Count that is encouraging parents, caregivers, grandparents, and friends to talk, read, sing and play with babies and toddlers given the lifelong impact of those early years.

The connection between literacy and health outcomes

At Welia Health, we’re committed to doing everything we can to ensure that people in our communities are healthy and happy. A key factor connected to both longevity and quality of life is whether you graduated from high school—a student’s ability to read at grade level by the third grade is the number-one indicator of whether that student will or will not complete high school.

It’s all connected

While Minnesota does better than most states with respect to literacy rates, we still need to do better. In 2015, City Pages reported that “Hundreds of thousands of Minnesota Adults Struggle to Read” and just last year, MinnPost featured an article titled, “Minnesota’s Persistent Literacy Gap has Lawmakers Looking for Ways to Push Evidence-based Reading Instruction.”

At Welia Health, we’re doing our part because literacy matters to people’s health. When people have low literacy skills, it can make it difficult for them to navigate their healthcare, even with our supportive staff at Welia Health. Plus, studies have shown that patients with inadequate literacy have less health-related knowledge, receive less preventive care, have poorer control over their chronic illnesses, and are hospitalized more frequently than other patients.

So, for the sake of our collective health, let’s read more to babies and toddlers and make sure that our third graders can read at grade level. Their futures depend on our commitment to their literacy.


Literacy and health outcomes: a systematic review of the literature


If you have a child in middle school or high school, you’ve likely seen their overloaded backpack. There’s a growing concern that kids are developing back, neck and shoulder pain and injury because of heavy backpacks.

  • One in four students report having back pain for 15 days or more during the school year.
  • In 2013, there were 5,415 backpack-related injuries treated at U.S. emergency rooms
  • 60% of students between ages 12 and 17 are carrying backpacks that weigh 10% (or more) of their body weight.

A loaded backpack should never weigh more than 10% of the child’s body weight (15% at absolute max). So a 100-pound child’s backpack shouldn’t weigh more than 10 pounds. A study in California showed that some textbooks weigh nearly five pounds each!

How to choose and wear a backpack safely

There are many ways to reduce back pain associated with backpacks that are too heavy. Here are some suggestions for you and your child to consider:

  • Never carry more than 10% of body weight.
  • Place the heaviest items close to the back.
  • Always use both straps.
  • Wider and more padded straps are better.
  • Don’t use leather straps as they add extra weight.
  • Keep the backpack above the hollow of the back.
  • Pick the smallest backpack that will work so it doesn’t get overloaded.
  • Use digital textbooks when possible.
  • Pack only what’s necessary.

As the school year continues, be sure to monitor your child’s backpack load. Listen for complaints about back, shoulder and neck pain. Watch to see if your child is struggling to get the backpack on or off or has to lean forward to carry the pack. These are signs that your child’s backpack is too heavy.


For many new moms, the year-old birthday is a relief: by definition, sudden infant death syndrome or SIDS doesn’t happen after that milestone. Babies are most at risk for SIDS between one and four months old—90 percent of cases occur in babies under six months.

Researchers are not sure what causes SIDS or why the risk drops when it does. That’s probably why it’s so nerve-wracking for parents of infants. While there’s no definitive way to prevent SIDS, there are specific steps you can take to reduce your baby’s risk.

  • Back to sleep. Since 1992, the number of infant deaths from SIDS has declined by more than half. That’s the year when the American Academy of Pediatrics recommended putting babies to sleep on their backs. Always place your baby on their back to sleep both for naps and at night. The back sleep position is the safest possible for all babies until age one.
  • Firm, flat sleep surface. Use a firm and flat sleep surface, such as a mattress in a safety-approved crib, with a tight-fitting sheet. Never place a baby to sleep on soft surfaces, such as a couch, sofa, pillow, quilt or blanket—they can be very dangerous for babies. Do not use a car seat, stroller, swing, infant carrier, infant sling or similar products as a baby’s regular sleep area.
  • Bare is best. Those matching crib bedding sets are adorable, no doubt. But is a cuter nursery worth risking your baby’s safety? To reduce the risk of SIDS, your baby’s crib mattress should be covered by a fitted sheet with no other bedding or soft items in the sleep area.
  • Room-share with parents. In 2016, the American Academy of Pediatrics (AAP) updated its sleep recommendations for infants. The AAP recommends that babies share a bedroom with their parents—but not the same sleeping surface—until the baby turns on (preferably), but at least for the first six months. Room-sharing decreases the risk of SIDS by as much as 50 percent.

    If you bring your baby into your bed for feeding or comforting, remove all soft items and bedding from the area. When finished, put your baby back in their separate sleep area. Be mindful of how tired you are during these times, so you don’t fall asleep with your baby in your bed. Note: There is no evidence for or against devices or products that claim to make bed-sharing “safer.”
  • Breastfeed, if possible. Babies who breastfeed, or are fed breast milk, are at lower risk for SIDS than are babies who were never fed breast milk. The longer you exclusively breastfeed your baby, the lower the risk of SIDS.
  • Pacifier for naps and bedtime. Pacifiers reduce the risk of SIDS. But don’t attach the pacifier to anything that carries a risk of suffocation, choking or strangulation. Wait until breastfeeding is well established before offering a pacifier (usually three to four weeks). If you’re not breastfeeding, offer a pacifier as soon as you’d like, but don’t force the baby to use it. If the pacifier falls out, it’s okay not to put it back in the baby’s mouth.
  • Marketing products aimed at reducing SIDS is just that marketing. Do not use home monitors or commercial devices, including wedges or positioners, marketed to reduce the risk of SIDS. Definitely don’t use ones that go against the AAP’s sleep recommendations.
  • Avoid baby’s exposure to smoke. Do not smoke or allow others to smoke around your baby to reduce the risk of SIDS.
  • Vaccinate. Follow guidance from your Welia Health provider on your baby’s vaccines. Vaccinated babies are at lower risk for SIDS.
  • Watch overheating during sleeping. Don’t let your baby get too hot during sleep. Dress your baby in sleep clothing, such as a wearable blanket (or sleep sack). Dress baby appropriately for the environment, but don’t overdo it. Parents and caregivers should watch for signs of overheating, such as sweating or feeling hot to the touch.
  • Tummy time. Supervised, awake tummy time—when someone is watching—is recommended daily to facilitate development. Supervised tummy time helps strengthen your baby’s neck, shoulders, and arm muscles.

There are also ways to reduce the risk of SIDS before your baby is even born. Get regular prenatal care during pregnancy. Plus, avoid smoking, drinking alcohol, and using marijuana or illegal drugs during pregnancy and after the baby is born.

If you have any questions about SIDS or ways to reduce the risk for SIDS, just ask your Welia Health provider or your baby’s pediatrician.


Choosing your baby’s name can be challenging. Do you go with a family name for the first name? For the middle name? Do you name your baby after your favorite movie or literary character? Do you want a popular name or an old-school one?

What if you and your partner just can’t agree on a name? How do you decide? Maybe your partner’s top choice is the name of your childhood nemesis. Sometimes it’s helpful to decide at birth. Your baby might not just look like the name you selected.

Then, the ultimate question: Do you share your list with friends and family? What if they hate every name on the list? (See: Jessica Simpson may have revealed her baby’s name—and everyone’s hating on it) What if your pregnant cousin is due before you?

There’s a lot to consider. To jumpstart your name-selection process, here are the top 10 most popular boy and girl names in 2019 (so far).

2019’s top ten most popular boy names (so far)

  1. Archie
  2. Milo
  3. Asher
  4. Jasper
  5. Silas
  6. Theodore
  7. Atticus
  8. Jack
  9. Aarav
  10. Finn

2019’s top ten most popular girl names (so far)

  1. Isla
  2. Olivia
  3. Aurora
  4. Ada
  5. Charlotte
  6. Amara
  7. Maeve
  8. Cora
  9. Amelia
  10. Posie

Source: Huffington Post

For other inspiration and insight on choosing your baby’s name, see these three blogs:


Breastfeeding has benefits for you, your baby and your budget. At Welia Health, we’re here to support you in your breastfeeding journey. In our experience, we find myths abound when it comes to breastfeeding. So we’re here to debunk some of the most common ones.

Myth: Breastfeeding should come naturally.

One of the common myths about breastfeeding is that the process should come naturally. But breastfeeding is actually a learned behavior, a skill. So while it’s biologically natural to breastfeed a baby, it takes practice, persistence, patience, and more practice and patience to master—and postpartum, patience is anything but virtuous.

Breastfeeding can be downright frustrating at first. But it’s so worth it. If you want to breastfeed your baby, it’s important to understand the other common breastfeeding myths.

Myth: Small breasts won’t make enough milk.

Breast size is determined by the amount of fat tissue. Milk-making capacity is determined by milk-producing cells in the breast’s glandular tissue.

Myth: Nipple shape matters.

Just as breast size differs and doesn’t matter in breastfeeding, nipple shape has little impact on successful nursing. During pregnancy, your breasts naturally undergo changes that ready them for breastfeeding. Even before your baby is born, the area around your nipples thickens, and glands in the areolas produce oils for lubrication and protection.

Flat or inverted nipples may self-correct when the baby arrives or just after—or they might not impact breastfeeding at all. Nipple shape can, at times, make breastfeeding somewhat more challenging. An experienced lactation consultant can help and might suggest breast shells or nipple shields, or manual manipulation of the nipple or breast.

Myth: Nipple pain is normal.

There’s a big difference between “common” and “normal.” Nipple pain is common, meaning many women experience it. But nipple pain is not normal. Nature designed breastfeeding to feel good, flooding a new mother’s system with feel-good hormones that relax us and spark mother-infant bonding. Pain fills us with stress hormones. When nipple pain occurs, it’s likely that there’s an issue with the baby’s “latch” or how the baby’s mouth is positioned on the nipple. If you dread nursing, are tense as your child nurses, or feel pain, something is amiss.

At Welia Health, we have board-certified lactation consultants who can help with your breastfeeding positioning and your baby’s latch. Contact us to make breastfeeding better for you and your baby.

Myth: If breastfeeding starts out difficult, it will just get worse.

Many women overcome breastfeeding challenges in a relatively short time period. Nipple pain, for example, can be an easy fix because it’s often due to a baby’s poor latch. Low-milk production or a baby who cannot latch can be more complex challenges to solve. But with the right support—and plenty of practice, patience and perseverance—you can successfully nurse your baby.

Myth: Skipping feedings won’t affect my production.

When you breastfeed your baby, it sends a message to your breasts and brain to produce milk. If you feed your baby from a bottle instead of the breast directly, extra milk can build up and engorge your breasts, which signals the brain to slow down milk production. To avoid engorgement and lower milk production, pump whenever your baby is fed with a bottle.

Myth: You will probably need to wean when you go back to work.

A mother pumps breast milk with electric breast pump.
A mother pumps breast milk with an electric breast pump.

Don’t let going back to work end your breastfeeding if you want to continue. You should be able to maintain your milk supply if you can pump once every three hours. If it’s not possible to pump that much during work (or you don’t want to), you can pump at other times and breastfeed when you are home with your baby. For example, you can pump immediately after breastfeeding at home, especially on weekends, to sustain milk production and store milk for the workweek.

Many working moms breastfeed their baby in the morning before leaving for work, in the evening after they get home, and on weekends and holidays. Then, caregivers feed the baby pumped breast milk or infant milk substitutes (formula). If you don’t pump at work, your milk production may decrease a little or it may decrease significantly.

By law, employers must provide nursing mothers with reasonable unpaid break time to express milk (pump) and a private room or other location for pumping, other than a bathroom or toilet stall, with access to an electrical outlet and in close proximity to the worksite. Employers can be held accountable for damages that occur due to non-compliance with this law.

Bottom line: It’s your right to breastfeed your baby, and pumping at work is a key part of that process if you want to continue to breastfeed after you go back to work. You may need to be creative, but it is possible to work and continue to breastfeed.

Myth: You need to breastfeed every two hours.

During the first couple weeks of life, babies should be fed every 2 to 3 hours (or about 8 to 12 times in a 24-hour period), according to the American Academy of Pediatrics. But once your baby is back to birth weight (by two weeks at the latest), you can start nursing when your baby shows signs of hunger or feeding cues. These signals include restlessness, smacking and licking lips, sucking on hands, or opening and closing her mouth. For most babies, a predictable feeding pattern emerges within a few weeks.

A related myth is that you should never wake a sleeping baby to breastfeed. But that’s only true if your baby is older than three months and a well-established breastfeeder. Days-old babies sleep a lot, and to create a breastfeeding routine and give your baby enough energy, you’ll need to wake her up and nurse her.

Myth: You can’t take medications when you’re breastfeeding.

Many medications are okay to take when you’re breastfeeding. If you’re taking one that isn’t, there might be a safe substitute. Your Welia Health provider can look up the most recent information on any medication you need.

If you have to take medication that is deemed unsafe during breastfeeding, pump and discard your milk while you’re taking the medicine. Then, just resume breastfeeding after it’s no longer in your system. Your Welia Health provider is happy to guide you through this process.

Myth: You have to “pump and dump” after you drink alcohol.

After you’ve had a drink, alcohol will leave your milk at the same rate that it leaves your bloodstream. To ensure your milk is alcohol-free, wait at least 2.5 hours before nursing again. You also could pump milk ahead of time in case your baby is hungry while alcohol is still in your system. Drugstores also sell dip test strips that you can use to make sure your milk isn’t tainted with alcohol. (See 6 Best Breast Milk Test Strips for Alcohol)

Myth: Breastfeeding will make my breasts sag.

Breasts will always change after pregnancy whether or not you breastfeed. Most women find that their breasts go back to their pre-pregnancy size and shape after they stop nursing. Age, the effects of gravity and changes in weight have more effect on breast size than nursing.

Myth: Formula is the same as breast milk.

Formula and breast milk both provide energy, hydration and nutrients. Your baby will grow regardless of whether you feed her breast milk or formula. But breast milk is the ideal food for your baby. Advances in formula will never come close to matching the health benefits* of your breast milk. Plus, breast milk is free!

One more fact about breastfeeding before we go.

Breast milk-fed babies have been studied to have reduced risks of:

  • Adolescent and adult obesity
  • Asthma
  • Celiac disease and inflammatory bowel disease
  • Childhood leukemia and lymphomas
  • Ear infections
  • Gastrointestinal infections
  • Respiratory infections, including bronchiolitis and pneumonia
  • Serious colds
  • Sudden Infant Death Syndrome (SIDS)
  • Throat infections
  • Type 1 and Type 2 diabetes
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