Most of us get heartburn from time to time. It may come as a burning sensation in the chest, or a bitter taste in the back of the throat. Heartburn is one word people use to describe reflux. It happens when stomach contents come back upwards. Reflux is sometimes painless: You may have trouble swallowing or get a dry cough, perhaps some wheezing.

Occasional reflux episodes are normal. Like millions of Americans, you can manage reflux by avoiding foods that don’t agree with you—things that are fatty, spicy or acidic—or by eating smaller meals. If reflux occurs less than once a week, you can usually cope by making lifestyle changes or using over-the-counter medications.

“We all have a little reflux when we burp or belch,” says Dr. John Pandolfino of Northwestern University. But of the 20 million or more Americans with reflux, about 5% have significant episodes 2 or 3 times per day. When severe events occur this often, it’s not ordinary reflux. It may be gastroesophageal reflux disease (GERD). You may need prescription medications to control it.

Surprisingly, there is very little data addressing sex differences in GERD--and perhaps this is one condition where sex differences only play a small role.  In the few studies that do exist, it appears that the overall incidence of heartburn, regurgitation, non-cardiac chest pain, and wheezing was the same in both sexes though there may be a higher intensity and frequency of symptoms in women but the clinical significance is not clear.   Heartburn is more prevalent during pregnancy and increases in each trimester but that  is believed to be due to anatomic changes such as the pressure of the expanding uterus or, possibility, something to do with progesterone level during pregnancy. It usually goes away after pregnancy.   Obesity and body mass index seems to increase the risk of GERD.

GERD should be taken seriously. Stomach (gastric) contents contain acid needed to digest food. In reflux, these contents wash upward into the esophagus, a slender tube connecting the mouth and the stomach. Because the lining of the esophagus isn’t meant to touch gastric acid, the acid can irritate the lining of the esophagus and lead to bleeding and scarring. In adults, GERD can raise the risk of cancer of the esophagus. And if you have asthma, GERD can make it worse.

As for babies, reflux is common in healthy infants. Most babies outgrow reflux by 13 months, but if they don’t, they too may have GERD.   GERD can harm a child’s ability to feed and grow. It can also increase the risk for inhaling stomach contents into the lungs which could be life-threatening.

People of any age can have GERD. Available medications, whether over-the-counter or prescription, can make the acid in the esophagus less intense. But medications don’t prevent GERD. Surgery can be an option if symptoms are severe and medicine and lifestyle changes don’t seem to help.  The problem isn’t that the stomach makes too much acid. In GERD, the special set of muscles between the esophagus and the stomach is weakened.  Scientists are beginning to look at how nerves receive and send messages to these muscles.

If you have reflux twice or more per week, talk to your health care provider. It’s best to start treatment early to prevent GERD from leading to more serious health problems.

How To Steer Clear of Reflux

Maintain a healthy weight.
Eat smaller meals.
Avoid triggering foods, including alcohol.
Don’t lie down for 3 hours after a meal.
Raise the head of your bed 6 to 8 inches by putting wood blocks under the bedposts.
For an infant, try burping frequently during feeding. Keep the infant upright for 30 minutes after feeding.
If you have reflux twice or more per week, see your health care provider.

An inexpensive instructional program to teach routine newborn care skills to midwives in Zambia resulted in a substantial reduction in the death rate of infants in the first week of life, according to a study funded by the National Institutes of Health and the Bill and Melinda Gates Foundation.

The study, published online in Pediatrics, was conducted by researchers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development’s Global Network for Women's and Children's Health Research.  "Public health officials and policy makers sometimes assume that only expensive, high tech-care can reduce infant mortality," said Linda Wright, scientific director of the NICHD Global Network for Women's and Children's Health Research. "The results of this study show that infant deaths can be prevented in resource-poor countries when only a modest investment is possible."

Each year, roughly 3.6 million infants die worldwide in the first 28 days of life, with the majority dying in the first seven days after birth, the study authors noted. Roughly 98 percent of these deaths occur in developing countries.

The researchers provided midwives from 18 first level delivery facilities in two Zambian cities with instruction in the World Health Organization's Essential Newborn Care Course. The course covers such newborn care basics as routine cleanliness, newborn resuscitation, keeping infants warm and dry, breast feeding, warning signs of potential problems, and dealing with common illnesses. The first level delivery facilities were small hospitals providing women with short term care — usually overnight — and attendance by a midwife, explained the study's senior author, Waldemar A. Carlo, M.D., a researcher in the department of pediatrics at the University of Alabama at Birmingham.

After completing the course, the midwives taught what they learned to other midwives in the facilities where they worked. In turn, these midwives taught what they had learned to the new mothers in their delivery facilities. The researchers compared the experiences of roughly 20,000 infants born in the delivery facilities before the midwives received newborn care training with the experiences of 20,000 infants born after the training period.

Infant mortality during the first seven days of life dropped from 11.5 for every 1,000 births to 6.8 per 1,000 births. The total cost for the training program was $20,244. The researchers estimated that the program saved 97 lives during the study period, amounting to a cost of $208 per life saved.

The researchers also evaluated the study costs in terms of disability-adjusted life years, a measure used by the World Health Organization to estimate the number of years of healthy life lost to premature death or to ill health. By comparing the number of lives saved as a result of the training to the average life expectancy in Zambia, the researchers estimated that a reduction of one disability-adjusted life year cost $5.24.

The researchers estimated that it would cost $14,128 to maintain the program in the future. This cost would include equipment replacement, training manuals, and salary for the program's two part-time nurses.

An earlier study by the NICHD Global Network for Women's and Children's Health Research found that Essential Newborn Care training for birth attendants in six developing countries reduced the rate of stillbirths by 30 percent.

Choosing a treatment option for breast cancer can be almost as confusing and frightening as the diagnosis itself. But it doesn’t have to be. A new study from the University of Michigan has found that women make smarter choices about treatments when they receive information and make decisions in small doses rather than all at once.

The researchers wanted to know if asking women to make a series of simpler choices instead of one complex decision would help them better understand the benefits of each treatment. In the study, researchers asked two groups of women to choose between different breast cancer treatment options. The first group got all the information and made all the choices at once. The second group received the same information, but it was divided into two separate choices: First they chose whether to take hormonal therapy, and if they said yes, then they decided whether or not to add chemotherapy.

The women who received the treatment options all at once were more likely to be confused by the information, and more of them chose chemotherapy regardless of whether it would give them a benefit of 1 percent or 5 percent. But the women who made their decisions separately were more likely to choose chemotherapy only if it would give them a larger benefit.

By presenting information piece-by-piece, doctors can help ensure that patients truly understand the benefits before they choose an aggressive treatment like chemotherapy, said Brian Zikmund-Fisher, study author and assistant professor at the University of Michigan School of Public Health. To read the full study, click here.

Now that so many women are balancing school, family, and work, it's hard to find time to stand up for women's causes.   But it is important and it does work.   Recently a prominent surgeon wrote a Valentine's Day editorial about the mood enhancing effects of semen on women during unprotected sex.   He cited a research study done in 2002 that reported that female college students who had had unprotected sex were less depressed that those who used condoms. It implied that compounds in semen have antidepressant effects.  He goes further to imply sex without condoms may be a nice Valentine's present. WHAT?#?#

The reaction from female doctors and especially female surgeons was almost immediate and full of outrage.   Guess what?  The surgeon (who was president-elect of the American College of Surgeons) submitted his resignation with little fuss, despite his many accomplishments and past support for women.     Even he must have felt that he went way over the line.   If you want to read the New York Times report on this incident, click here.

Even better, think about what is important to you as a woman related to health and if you find some shortcomings, find the time to speak out!