🤰 Tutorial and User Manual · CaVeSal® Mamá

0 · Welcome in 30 seconds: choose your stage

The first time you open the App, it asks which stage you're in so it can show you only what you need, without overwhelming you with the rest.

1 · Install the App on your phone

CaVeSal® Mamá works in your browser and can also be installed as an app, with no store and barely any storage space.

2 · Your profile and your dates

Based on Robinson & Fleming 1975 · ACOG Committee Opinion 700 · Hadlock 1984

2 bis · The pregnancy calculator (free forever)

Based on ACOG Committee Opinion 700 · Robinson & Fleming 1975 · Hadlock 1984

The gestational age calculator is the free part of the App: you don't need a trial or a key to use it, today or ever.

• Biological age of the baby: counted from fertilization (about 2 weeks less).
• Chronological or obstetric age: counted from the last menstrual period, and it's the one your doctor uses for all calculations and studies.
• Both are correct: what changes is the starting point. The App shows you both so you don't get confused when you hear different numbers.

2 ter · Review and correct your data in the result

Below the result there's a panel to review what you entered and correct it without going back: the calculation updates instantly.

• You can change the LMP, the ultrasound date and the weeks/days it reported.
• You can choose which basis you want the calculation on: LMP, ultrasound or corrected LMP.
• Right there, the difference between biological age and chronological age is explained.
• Your data stays saved on your phone: next time, the questionnaire comes pre-filled and you just confirm or edit it.

2 quater · “When will I reach…” calendar

A calendar of its own to find out exactly which date you'll reach each week or each month of pregnancy.

• Choose the week or month and the App gives you the exact date and how many days are left.
• The result is shown in weeks and days, calendar months and lunar months.
• It's useful for scheduling your check-ups, ultrasounds and studies ahead of time.

2 quinquies · Bringing your dating to your doctor (free forever)

Below the result you'll find the “Bring my dating to my doctor” block: everything that comes out of it is free, even without a trial or a key.

• Dating PDF: your name, LMP, ultrasound, weeks and days, trimester, calendar and lunar months, due date, LMP vs. ultrasound comparison, corrected LMP with its threshold, and the explanation of biological vs. chronological age.
• Dating file: a file with only your identification data, LMP, ultrasound and due date, which your doctor can open or import.
• Link and QR code with your dating, to send by WhatsApp, email or SMS, or to show at the clinic.

3 · Week by week and baby development

In Week you'll find, for your current week and for any other week: approximate size and weight, comparison with a fruit, what your baby is developing, what you may feel, sensory milestones and a “did you know…?”.

4 · Weight, blood pressure and expected gain

Based on IOM/NAS 2009 · ACOG Committee Opinion 548

5 · Studies, labs and ultrasounds

Based on ISUOG · ACOG · IADPSG/ADA · ETMI Plus Paraguay

• Checklist by trimester: which lab work and which ultrasound apply and in which weeks.
• This week you need: on the home screen and in Week by week you see the lab work, ultrasound and check-ups for your week, what is overdue and what opens next week.
• Understanding my tests: one card per test with what it is for, what normal means, what an abnormal result may mean and what comes next. It opens from each item of your plan.
• Vaccines, the dental check-up and the Pap smear are now items you can tick off, each with its week window.
• Interactive baby: in Week by week you tap the illustration and see which organ or milestone is developing that week.
• Hospital bag: a tick-off list for mum, baby, your birth partner and documents, with a planned-caesarean variant, your own items, PDF and a reminder from week 34.
• Attach results: take a photo or upload the PDF and it stays saved alongside the study.
• Export to calendar: generate an .ics file with your pending studies.
• Share: send the summary of upcoming studies by WhatsApp or email.

6 · Schedule, reminders and medication

7 · Fetal growth and percentiles (CaVeSal® scale)

Based on Hadlock 1984 · INTERGROWTH-21st · Figueras & Gratacós · ISUOG Delphi 2020

7 bis · One baby or twins: tracking by baby

Based on NICE NG137 (2019, updated 2024) · ISUOG 2016 · ACOG/SMFM PB 231 (2021) · WHO 2016

• The guide explains how identical twins and fraternal twins form, what's inherited and what extra check-ups are needed.
• Weight difference: less than 10% is expected, 10 to 19% is monitored closely, 20% or more is considered significant, and from 25% up the consultation is a priority.
• Each growth-difference alert tells you what criterion triggered it, what it means, what is usually checked, what to ask at your check-up, and whether the difference is growing or shrinking.
• In the sleep and feeding panel you see sleep hours, naps and longest awake stretch compared with what's typical for that age, an alert when a baby has been awake for a long stretch, and a table comparing both siblings.
• If they share a placenta, besides weight, the fluid in each sac is checked (twin-to-twin transfusion) by ultrasound every 2 weeks from week 16 on.

8 · Album, names and sharing

• My pregnancy album: save bump photos and ultrasound photos by week (they stay on your phone).
• Names: explore ideas and save your favorites.
• Visit report: generate a PDF or Word summary to bring to your check-up.
• Share the App: from More → Share, send the link and QR code to another expecting mom.

9 · Labor, postpartum and baby's first year

Based on WHO/UNICEF · WHO intrapartum care 2018 · ACOG Clinical Practice Guideline 8 (2024), Practice Bulletin 209 and Committee Opinion 736 · ASA/SOAP · AAP 2022 · WHO growth curves · CDC

• Labor: signs of labor, what to bring to the hospital and when to go.
• Step-by-step breathing and relaxation: slow 4-6 breathing, contraction breathing, candle-blowing breath, low-pitched voice, body scan, visualization, sacral counter-pressure and warm water.
• Anesthesia according to your pain threshold and your doctor's guidance. During labor: local, pudendal block, cervical (paracervical) block, spinal, epidural, combined spinal-epidural, nitrous oxide or opioids. For a C-section: spinal and epidural, and general anesthesia (putting you to sleep) only in obstetric emergencies.
• Postpartum: care, warning signs and breastfeeding step by step.
• Practical breastfeeding guide with illustrations: good latch, cradle hold, 20 to 25 minutes per breast, switching to the other breast, how to burp your baby, and which breast to start with next time.
• Nipple care (water or virgin coconut oil), how to increase milk supply with frequent feeds, when to consult, and what to limit during breastfeeding.
• Safe newborn sleep: always on the back after burping, never on the stomach, to reduce the risk of sudden death.
• Baby's first year: feeding, vaccines, developmental milestones and WHO growth curves for weight, height and head circumference.

9 bis A · My baby month by month: plan, routine and check-ups

Based on WHO Nurturing Care Framework (2018) · WHO/UNICEF infant feeding · AAP Bright Futures 4th ed. · AAP Safe Sleep 2022 · CDC revised milestones 2022

In My Baby, besides the week-by-week view, you'll find an age-based plan for the first year: short things to do today, the daily routine, and a sheet to bring to the pediatrician. None of this is a mandatory task: it's a helping hand so you're not left wondering “now what do I do with him/her?”.

• Plan by age (0 to 12 months): the App looks at your baby's age and suggests short activities for bonding, motor skills, language, senses and calming, with the time of day and how many minutes it takes. What you check off is saved on your phone and resets clean the next day.
• Each stage also brings what to watch for (what's expected at that age, without rushing), when to consult, and which check-up or vaccine is due.
• “My day”: you enter when your baby wakes up, when they go to sleep at night, how many naps they take, how often they eat, and bath time, and the App builds the day's grid with feeds, naps, play, bath and music therapy according to age. You can check off what happened, copy the day, or download it as a PDF.
• The routine is only a guide: on-demand breast or bottle feeding always wins. If your baby asks earlier, feed earlier.
• Printable cards by stage: one sheet per age, in plain words, with what your baby does, what you can do, how eating and sleeping are going, when to call the pediatrician, and the upcoming check-up. You can download just the current stage or the full first-year booklet.
• Tracking PDF for the pediatrician: it gathers milestones, activities you've done, alerts you've flagged, and family notes, so you don't forget anything at the appointment.
• Photos chosen by you: in the gallery you filter by stage or date range, check off the ones you want in the PDF, and reorder them with the arrows. If you don't choose any, the most recent ones are used. Each photo comes with its caption: date, age and stage.
• Next pediatrician visit: you write down the date, time, pediatrician and what you want to ask. The App reminds you beforehand, adds the alert to your phone's calendar, and as the day gets closer, drafts a ready-to-send text (baby's name, age and corrected age, milestones and your questions) to copy or send by WhatsApp or email.
• What's available at each age: a checklist by stage (newborn, 2, 4, 6, 9 and 12 months) that tells you how many items the App has for that age across developmental milestones, warning signs, nutrition, vaccines, pediatric check-ups, sleep, growth and percentiles, warning signs, breastfeeding and plan activities. Tap each module to see the detail, and you can copy the full checklist.
• Growth curves and measurement log: you can enter weight, height and head circumference by hand or import a spreadsheet from 0 to 12 months; the App calculates the age in months from the date, warns if a value is out of range, and shows the percentile for that age.
• Everything is generated on your phone and is only shared if you decide to.

9 bis B · From 6 to 12 months: food, vaccines and warning signs

Based on WHO/UNICEF complementary feeding · WHO Labour Care and WHO growth curves 2006 · AAP Bright Futures · CDC revised milestones 2022 · Paraguay PAI (MSPBS) · NIAID/LEAP for allergens

The second half of the year brings a lot of change: your baby sits up, crawls, puts everything in their mouth and starts eating from the family pot. That's why in My Baby we cover the whole year: milestones at 9 and 12 months, how food progresses, the vaccines still due, check-ups, and the warning signs specific to this age.

• Milestones at 9 and 12 months: what's expected socially, in language (meaningful babbling, first words), in movement (sits alone, crawls, stands, walks holding a hand) and in the pincer grasp, along with the list of when to consult.
• Food step by step: from 6 to 9 months, thick purées and mashed food; from 9 to 12 months, soft finger foods, 3 meals plus a snack, and iron every day.
• Allergens: offered early and one at a time (well-cooked egg, diluted peanut paste, boneless fish), not delayed without reason.
• The difference between a gag (makes noise, coughs, turns red: it's a learning process) and true choking (no sound, no cough, turns blue: it's an emergency).
• Forbidden until age one: honey, added salt and sugar, cow's milk as a drink, whole nuts, whole grapes and cherry tomatoes, sliced sausage rounds.
• Sleep from 6 to 9 and from 9 to 12 months: how many hours and naps are expected, without dropping the back-sleeping and own-crib rule.
• Second-half and one-year vaccines: second flu dose and the 12-month block (MMR, chickenpox, hepatitis A, pneumococcal booster and yellow fever depending on your country's schedule).
• 9- and 12-month check-ups: what the pediatrician looks at, the weight, height and head-circumference curve, hemoglobin if ordered, and oral health.
• Breastfeeding up to age one and beyond: the breast continues for as long as both of you want; breast first, then the plate, until the baby asks for more food than milk.
• Warning signs from 6 to 12 months: dehydration, choking, fever that won't come down, loss of skills already gained, paleness or lethargy.

9 bis · My postpartum, stage by stage

Based on PAHO/WHO · MSPBS Paraguay · ACOG postpartum care · Williams Obstetrics

In Labor › My Postpartum, we walk with you from delivery of the placenta through the 40-day recovery period, with our own illustrations.

• The placenta: what it did for your baby and how the afterbirth (delivery of the placenta after birth) happens.
• The four postpartum stages (immediate, early, late and remote): what's expected in each one, what's watched most closely, and when the check-ups are.
• Uterine involution: how the uterus returns to its size and what can be felt each day.
• Lochia: how it changes in color and smell, how long it lasts, and the false return around day 20.
• The 40-day recovery period: rest, hygiene, the wound or episiotomy, and when intercourse can resume.
• “When is it urgent to consult?” button at the top of the screen: opens a short summary of the reasons for immediate postpartum consultation, the steps to follow, and also the pregnancy warning signs.

9 ter · Breastfeeding tools

In Labor › Breastfeeding you'll find the guides, plus two tools to use while you nurse.

• Breastfeeding timer: tracks the 20 to 25 minutes per breast, alerts you to switch breasts, reminds you to burp, and keeps a history to suggest which breast to start with next feed.
• Step-by-step carousel with illustrations: good latch, positioning, burping and back-sleeping.
• How much milk and what it's made of: the three stages (colostrum, transitional milk and mature milk) with expected volumes per day, so the small amount in the first days doesn't scare you.
• What's in every 100 ml of mature milk, and why the milk at the end of the feed is fattier: that's why it's best to fully empty one breast before offering the other.
• The history stays only on your phone, like all your data.

9 quater · Contraception after delivery

Based on WHO Medical Eligibility Criteria · CDC US MEC · FSRH

In Labor › Contraception we explain each method in plain words, from when it can be used if you're breastfeeding, to how effective it really is.

• LARC methods (long-acting and the most effective): subdermal implant, copper IUD and levonorgestrel IUD.
• Hormonal methods taken daily or monthly, injectables, and their compatibility with breastfeeding.
• Condoms: the only method that also protects against sexually transmitted infections; how to use them correctly and what ruins them.
• Pearl Index in two columns —perfect use and typical use— so you can see the difference between what the leaflet says and what happens in everyday life.
• LAM (breastfeeding as contraception): its three conditions and why it's best to add another method.

9 quinquies · Choking and baby routines

Based on American Heart Association 2020/2023 · European Resuscitation Council 2021 · AAP

In My Baby we've added first aid and day-to-day routines, with interactive checklists so you don't skip steps.

• Under 1 year old, the Heimlich maneuver is NOT used: it's 5 back blows and 5 chest thrusts, alternating.
• How to tell effective coughing (let them cough, don't put your fingers in their mouth) from complete obstruction (no crying, no coughing, turning blue: start the maneuvers right away).
• Interactive emergency checklist: each step is confirmed and the next one is unlocked, so you follow the sequence without getting lost.
• Routine checklists: bath time, umbilical cord care, and the nighttime routine (sleep-wake).
• “When is it urgent to consult?” button: summary of newborn warning signs, immediate steps, and pregnancy warning signs.
• Prevention: no nuts, whole grapes, hard candy or small toys, and never leave your baby alone while eating or with a propped-up bottle.

9 sexies · Baby's position and descent during labor

Based on ACOG Committee Opinion 745 and Practice Bulletin 161 · RCOG Green-top 20a and 20b · Term Breech Trial (Lancet 2000) · Williams Obstetrics 26th ed. · WHO intrapartum care 2018

In Labor › Baby's Position we explain, with our own illustrations, how your baby may be positioned, why it's normal for them to be breech or transverse until the eighth month, and how the head descends during labor.

• The three positions with an interactive silhouette: cephalic (head down), breech (bottom down) and transverse (sideways), with the actual frequency of each.
• Pajot's law of accommodation: up to 32-34 weeks your baby moves freely, and afterward settles on its own, because its shape fits better head-down along the uterus's longest axis.
• Timeline in weeks: at 28 weeks, 1 in 4 babies is breech; at 32 weeks, only 7 to 8 in 100 remain breech; at 36-37 weeks the presentation is confirmed; and from 37 weeks the plan of care is decided.
• If it persists: scheduled C-section is the preferred route (and the only option for transverse position); vaginal breech birth is reserved for very selected cases and centers with trained teams.
• External cephalic version from 36-37 weeks, at a center with an operating room and monitoring: it's mainly considered as a last resort when a C-section isn't available and transfer isn't possible.
• Interactive graphic of cephalic descent: DeLee stations from -3 to +3 and Hodge planes I to IV, with what you feel at each point and the movements of labor in order.

9 septies · Sexuality during pregnancy and postpartum

Based on ACOG FAQ Sex During Pregnancy and Committee Opinion 736 · WHO postnatal care 2022 · NICE NG194 · RCOG Green-top 27a and 63 · WHO/CDC contraceptive eligibility criteria

In Labor › Sexuality we bring together pregnancy and the 40 postpartum days in a single guide, in plain, direct language.

• Healthy pregnancy: sex is safe, the penis doesn't reach the baby, and orgasm doesn't bring on labor. How desire changes each trimester and which positions are more comfortable.
• When your doctor advises waiting: placenta previa or low-lying placenta, unexplained bleeding, ruptured membranes, threatened preterm labor, short cervix or cerclage, active infection, and prescribed bed rest.
• Signs to consult after intercourse: bleeding, fluid loss, severe pain or contractions that don't stop.
• The 40 postpartum days (recovery period): why penetration, immersion baths, pools and tampons are restricted while the uterus heals and there's lochia.
• When intercourse can resume: without bleeding, without pain, and with clearance from the 4- to 6-week check-up, depending on whether it was a vaginal birth with episiotomy or a C-section.
• Dryness and pain from breastfeeding: water-based lubricant, positions you control, pelvic floor exercises, and when to ask for physical therapy.
• You can get pregnant before your first period returns: ovulation can come back around day 21 to 28, which is why contraception is decided before resuming intercourse.

9 octies · Postpartum care, day by day

Based on WHO postnatal care 2022 · ACOG Committee Opinion 736 · Williams Obstetrics 26th ed. · RCOG · MSPBS Paraguay

Inside Labor › My Postpartum you'll now find, besides the stages, everything that's monitored and watched over at each point, with a checklist you can print or bring to your check-up.

• What's monitored in the first 24 hours, from day 2 to 10, and up to day 42, with a separate list for C-sections.
• How much the uterus goes down each day: where it can be felt and what's expected, so you know it's going well.
• Afterpains (the cramps you feel while breastfeeding): why they hurt, how long they last, and what helps.
• Wound care: perineum or episiotomy and C-section scar, with what to do and what not to do.
• Peeing, pooping and drinking water without fear, and what happens when your milk comes in between day 3 and 5.
• Postpartum supplements (iron, folic acid, calcium and iodine) with the usual doses to discuss with your doctor.
• Baby blues or postpartum depression: how they differ and at what point you must ask for help.
• My postpartum checklist by stage: saved on your phone and downloaded or shared as a PDF, whole or by stage.

9 nonies · Partner and desire after delivery

Based on ACOG · WHO postnatal care 2022 · Basson's sexual response model · Sultan (perineal trauma)

Labor › Partner and Desire is a new tab that talks about something rarely discussed: why desire drops postpartum and during breastfeeding, and what can be done about it.

• What happens in the body: high prolactin and low estrogen, dryness, lower androgens, oxytocin already being released with the baby, and tissues that are still healing.
• What happens in the mind: feeling “touched out” from so much contact, lack of sleep, a body that has changed, unevenly shared mental load, and the shift from lovers to caregivers.
• What really helps: vaginal lubricants and moisturizers, pelvic floor physical therapy, intimacy without genitals, and Basson's model (closeness first, then desire).
• Why there's no penetration in the first month: risk of infection inside the uterus, healing and bleeding, explained in plain terms so it's understood as a couple.
• Sheet for couples to talk it over: it can be copied and sent, and includes concrete questions for the 6-week check-up.
• A 6-question pain self-check with a traffic-light result: it tells you whether it's worth mentioning at your check-up or asking for a specific consultation, and builds a copyable summary for your doctor.

10 · Preconception stage

If you're still trying to conceive, the App calculates your ovulation and fertile days and walks you through preconception recommendations. It's free.

• Original illustrations of the menstrual cycle: hormones, follicle, ovulation, corpus luteum and endometrium.
• Fertilization on day 0 and the journey of the fertilized egg to implantation, around day 7.
• The zygote (day 1) and the morula (days 3 and 4), which are weeks 1 and 2 in your doctor's count: they happen before your missed period, which is why they almost never match the moment you find out you're pregnant.
• Why beta hCG can only be measured after implantation, even though the pregnancy started a week earlier.
• The difference between the baby's biological age (from fertilization) and the chronological or obstetric age your doctor uses (from the last menstrual period).
• Interactive timeline from day 0 to implantation: tap each day to see what's happening and from when it makes sense to test beta hCG.

10 A · Preconception visit and traffic-light system 🟢🟡🔴

Based on Paraguay MSPBS National Prenatal and Perinatal Care Guidelines 2022-2025 · WHO

Inside “I want to get pregnant → Visit and traffic light” you'll find the complete flowchart of the pre-pregnancy visit, in four steps, and the three traffic-light cards with the criteria and course of action for each level.

• 🟢 Low risk: everything is stable, you can try to conceive with folic acid supplementation and routine check-ups.
• 🟡 Intermediate risk: there's something to stabilize first (weight, anemia, thyroid, blood sugar, blood pressure, vaccines, habits), and it's recommended to wait and reassess.
• 🔴 High risk: trying to conceive is postponed and you're referred to high-risk care or the relevant specialty.

10 B · I have polycystic ovary syndrome / I'm overweight

Based on International PCOS Guideline 2023 (ESHRE · ASRM · Monash) · WHO · ACOG · NICE · ASRM · Endocrine Society

Inside “I want to get pregnant → PCOS and weight” you'll find the complete guide to polycystic ovary syndrome (now also called PCOM, polycystic ovarian morphology) and to weight before pregnancy, with a built-in BMI calculator.

• What PCOS is in plain words, why the name changed to PCOM, and why “polycystic ovaries on ultrasound” isn't the same as having the syndrome.
• The acronyms translated: PCOS/PCOM, BMI, hyperandrogenism, anovulation, insulin resistance/HOMA and AMH.
• BMI calculator with your weight and height, an explained category, and a realistic weight-loss goal: 5% and 10% of your weight, in concrete kilograms.
• How PCOS and weight affect fertility, and the insulin–androgen–abdominal fat cycle that explains why they go hand in hand.
• Lifestyle: the plate that helps most, two full sample days of meals (one home-cooked, one for a rushed day), and shopping tips.
• Aerobic exercise plan in three levels, building up to 150–300 minutes a week plus two strength-training days, with signs to ease off.
• What your doctor might prescribe: anti-androgenic contraceptives, metformin, GLP-1 medications (semaglutide and similar) and myo-inositol, and why a team of OB-GYN + endocrinologist + nutritionist is best.
• If anovulation persists: ovulation-inducing pills (letrozole as the first option or clomiphene) and, if there's no response, injectable FSH/HMG with ultrasound monitoring.
• Seven sources with clickable links and a button to copy the bibliography, plus the exact citation under each block.

10 C · Nausea and vomiting: why it happens and what to do

Based on ACOG Practice Bulletin 189 (2018) · RCOG Green-top 69 (2016) · SOGC 2016 · Cochrane

In Guides › How to reduce nausea we explain why it happens (the pregnancy hormone, hCG, rises until weeks 9 to 12 and then falls, so for most people it goes away between the third and fourth month), what makes it worse, and how much is expected.

• Balanced, spread-out diet: 5 or 6 small meals a day, because both hunger and an overly full stomach trigger nausea.
• Cold helps: ice cream, gelatin, ice pops, chilled fruit and very cold drinks in sips. Hot foods and their smells are the most common trigger.
• Avoid citrus and acidic juices, fried foods, heavily seasoned meals, and anything that turns your stomach.
• Vomiting a lot causes loss of vitamin B6, and that deficiency makes nausea worse; fatigue and stress don't cause it, but they make it worse.
• If you're expecting twins or there's a molar pregnancy, the hormone level is higher and nausea can be more intense — that's why your doctor may order an ultrasound.

10 quater · Your breasts, colostrum and skin changes

Based on Riordan & Wambach · StatPearls Anatomy of the Breast 2024 · Williams Obstetrics

In Labor › Breastfeeding and in Guides you'll find original illustrations of breast anatomy and the normal changes of pregnancy.

• Parts of the breast: nipple with its 9 to 15 ducts, areola, Montgomery and Morgagni tubercles, alveoli where milk is made, and ducts. Breast size doesn't determine how much milk you'll produce.
• Colostrum is prepared starting halfway through pregnancy, is thick and comes in small amounts (that's the correct amount), and acts as your baby's first vaccine.
• Milk “comes in” between 48 and 72 hours after birth; from days 3 to 14 it's transitional milk, and from the second or third week it's mature milk.
• Normal skin changes: dark line on the belly, chloasma or melasma on the face (sun makes it worse: sunscreen every day), a bigger and darker areola, stretch marks, and hair loss at 2-4 months postpartum.
• No nipple preparation is needed: don't rub, brush or pull on them.

10 sexies · Teeth and gums in pregnancy

Based on ACOG Committee Opinion 569 (2013, reaffirmed 2020) · Joint EFP/AAP consensus 2013 · MSPBS Paraguay 2022 · AAPD 2022

In More › Teeth and gums in pregnancy we explain why gums swell and bleed, what can be done in each trimester, which anesthesia and medicines are safe, and how to care for your baby's mouth. This is a Premium screen.

• 6 to 7 out of 10 pregnant women have swollen gums that bleed when brushing: this is pregnancy gingivitis, caused by hormones plus plaque. You don't stop brushing: you brush better and more gently.
• The little red lump that bleeds on the gum (epulis or pregnancy granuloma) is benign and usually goes away on its own after birth.
• If you vomit, don't brush right away: rinse with water or water with baking soda and wait 30 minutes, because the acid softens the enamel.
• Myths: you don't lose “a tooth for every child”, and local anesthesia and dental X-rays with a lead apron are fine in pregnancy. Leaving an infection untreated is what is truly risky.
• Badly diseased gums (periodontitis) are linked to premature rupture of membranes, preterm birth, and low birth weight: bacteria and inflammation reach the placenta and membranes through the blood.
• Timing: in the first trimester, assessment, cleaning, and emergencies; weeks 14 to 28 are the ideal window for fillings, root canals, and extractions; in the third, maintenance and a half-seated chair with a pillow under the right hip to avoid Poseiro syndrome.
• Medicines: 2% lidocaine with epinephrine is the anesthesia of choice and acetaminophen is the safe painkiller; ibuprofen only occasionally in the second trimester and never in the third; amoxicillin as first line (clindamycin or azithromycin if you're allergic), and tetracyclines or doxycycline are forbidden because they stain the baby's teeth.
• Cavities are contagious: Streptococcus mutans passes from your saliva to your baby's when you share spoons, blow on food, clean the pacifier with your mouth, or kiss them on the mouth. Caring for your mouth is caring for theirs.
• Clean your newborn's gums with a damp gauze and brush from the first tooth (around 6 months) with fluoride toothpaste of 1,000 ppm or more, a rice-grain amount. No bottle with juice or sweetened milk to fall asleep.

10 quinquies · Crying, colic and early stimulation

Based on AAP 2022 · Wessel 1954 · Barr, Period of PURPLE Crying · Zeevenhooven 2017 · CDC 2022

In My Baby › Sleep and Development, we've added why babies cry, how to soothe colic, and what your newborn sees, smells and hears.

• Why babies cry: hunger, diaper, gas or colic, discomfort, tiredness or overstimulation, needing to be held, and finally pain (a sharp, distinct cry that won't stop: consult for that one).
• Colic: crying for more than 3 hours a day in a healthy baby, peaking at 6 weeks and improving toward 3-4 months. It's understood mainly as nervous-system maturation — which is why it's worse in the evening — with a digestive gas component in some babies.
• What helps: clockwise belly massage, bending the legs, burping after each breast, skin-to-skin contact, swaddling, white noise, a stroller or car ride, and a warm bath.
• No simethicone, probiotics, drops or teas on your own: their effect is small or none, and some carry risks. It's always prescribed by your pediatrician.
• On-demand breastfeeding, but without going more than 3 hours during the day or 4 to 5 at night in a newborn, because of the risk of hypoglycemia.
• Early stimulation: focuses sharply at 20-30 cm (the distance from your face while nursing), recognizes your smell and voice from the womb, and dad's too. Awake tummy time, talking and singing to your baby; no screens before age 2.
• Milestones revised per CDC 2022: steady head control at 4 months, sits alone between 7 and 9, crawls between 7 and 10, first steps between 11 and 15 months (normal up to 18).

10 ter · The pregnancy test: hCG, beta hCG, and your missed period

In Preconception › Cycle, we explain from which day of a missed period each test turns positive, and why you might be pregnant with a negative result.

• hCG appears with implantation, around day 7 after fertilization: before that there's nothing to measure.
• Quantitative beta hCG blood test: the most specific, and the one that turns positive earliest, around day 8 to 11 (one to three days before your missed period), from 1 to 5 mUI/mL.
• Over-the-counter urine test: usually turns positive 1 or 2 days after a missed period (detects from 20 to 25 mUI/mL, some from 10) and is almost always positive between day 3 and 7 of a missed period.
• Urine hCG and total hCG in blood can give false positives due to cross-reaction with similar hormones (LH, FSH, TSH), medications containing gonadotropins, or readings taken outside the recommended window; the beta subunit is the one specific to pregnancy.
• A very early negative test, with late ovulation or diluted urine, doesn't rule out pregnancy: repeat it in 48 to 72 hours using the first morning urine.

11 · Let's chat with AI

Let's Chat answers your pregnancy questions in plain language, with daily messages throughout your 12-month subscription, and a higher daily limit on days when you upload and review the result of a study.

• It answers in the language you chose in the App: Spanish, Portuguese or English. If you change it, the next reply already comes in that language.
• Responsible use: up to 20 messages a day, and once every 15 days you can extend that day to 50 messages.
• If you share a study result with it, it explains it in plain words and suggests what to ask your doctor.

12 · Free trial, plans, and activating your key

When you buy your plan, you receive an activation key by email. With that key and a PIN you choose yourself, you activate the App on your phone. There's no verification code to complete: just the key and your PIN.

• Free forever: your gestational age calculation, the LMP vs. ultrasound comparison, the corrected LMP, the “when will I reach…” calendar, and exporting it as PDF, file, link and QR.
• Try everything else free for 7 days, with no card and without giving us any data.
• During those 7 days you browse anonymously: activating your key and creating your PIN is optional and never appears as mandatory on the cover screen.
• Once the 7 days end we do ask for your email and PIN once, even if you stay on the free version: without them you cannot export or send your data to your doctor (link, QR, PDF, file or WhatsApp), because it goes out with your name on it.
• Plans are yearly: a single payment that covers 12 months. Premium USD 11.9 (US$0.99/month) and Premium Plus USD 29.9 (US$2.49/month).
• Premium (12 months): full pregnancy and baby tracking.
• Premium Plus (12 months): also includes Let's Chat with AI. If you already have Premium, you can upgrade to Plus by paying the difference.
• The activation key is personal: it's tied to your name and email, and that data is locked once activated.
• With a card or an international wallet: you pay in a minute from the App and the key arrives on its own by email, with no waiting.
• Without a card (bank transfer or digital wallet, designed for Paraguay): you leave your order in the App, transfer, upload your receipt, and CaVeSal MFI emails you the same key.

12 bis A · How to buy (with or without a card) and your invoice

There are two ways to buy your plan and both deliver the same key, with the same rules (account holder, PIN, 2 devices). Pick whichever suits you.

• With a card or international wallet: you pay online from the plans screen and the key arrives on its own by email, at any hour.
• Without a card: bank transfer or digital wallet. In Paraguay many people don't use cards, so this route exists for them.
• When you leave your order in the App you get a reference (for example MAMA-A1B2C3), the exact total, and the account details to transfer to.
• You upload your transfer receipt inside the App, in your own order: it stays private and only CaVeSal MFI sees it to verify the payment.
• In Paraguay the total is charged in guaraníes at the day's exchange rate with 10% VAT included and itemized; from abroad the sale is tax free, with no Paraguayan VAT.
• The transfer receipt is not an invoice: CaVeSal MFI issues the invoice in your name and with your ID or tax number if you need it for your records.
• If you pay by card, the purchase receipt comes from the payment provider itself along with the key.
• Questions and direct purchase: WhatsApp +595 983 361 482 or drverasalerno@gmail.com, always with your reference at hand.

12 bis · Sending your data to your doctor

From Home → “Send my data to my doctor” you can pass your dating along to your provider, choosing the channel that works best for you.

• Free forever: your name, your LMP, the date and weeks of your ultrasound, and your due date, via link, QR code, WhatsApp, email or SMS.
• Also free: “Save a copy to my phone” — it saves a file trimmed down to just your dating (name, LMP, ultrasound and due date).
• Premium: labs, TORCH panel, ultrasound reports, Doppler, medical history, and the file (JSON) to import into the CaVeSal® Medical Record.
• Premium Plus: also the AI-written summary of your visit.
• The message is automatically filled in with your name, the date, and your doctor's name, and you can copy it to your clipboard if your phone doesn't allow attaching files.

12 ter · Quick guide for your doctor (PDF)

A one-page PDF so your provider understands in a minute what you're sending them and what they can do with it.

• Explains the free mode: what dating data is received via link, QR, WhatsApp, email or SMS.
• Explains how to import the Premium (JSON) file into the CaVeSal® Medical Record, step by step.
• It can be downloaded from the screen for sending to your doctor, and can also be shared along with the link or the file.

13 · Your data, backup and deletion

• Your data, photos and attachments are stored only on your device.
• In More → Backup, tap “Create backup” to download a file with everything you've entered, including your selections and records for each baby (A and B) if you're expecting twins.
• You can check “Include photos” so the file also includes the album, baby photos and cover photo. Without that box checked, the backup is lighter.
• On a new phone, tap “Restore backup”, choose the file, and you'll first see a summary (date, stage, single or twin pregnancy, and how many records there are per baby). The data is only replaced once you confirm.
• The backup isn't uploaded to any server: the file stays in your possession and contains health data, so keep it somewhere safe.
• The activation key, the PIN and the authorized device don't travel in the backup: on the new phone you activate the key as usual.
• If you'd rather not handle files, in More → Automatic cloud backup you can turn on syncing: with your session signed in (email and PIN), the app saves a copy to your account on its own, and on another phone you tap “Bring from the cloud”, see the summary, and confirm. The backup is private: only you can see it, and your key and PIN never travel in it.
• In More → Danger zone you can reset your data or start a new pregnancy.
• If you set your own photo on the cover screen, it's saved only on your phone: it isn't uploaded to any server and doesn't travel in the file for your doctor or in anything you share.

14 · Warning signs

Based on PAHO/WHO · MSPBS Paraguay · ACOG Practice Bulletin 222 (2020) · RCOG Green-top 57 · ISSHP 2021

The App has a section with the reasons to consult immediately, in English, with the original Spanish and Guaraní terms used in Paraguay kept alongside for reference. It's a single list, the same one you see in the App and in this manual.

• Vaginal bleeding — Hyvypa iparte pe: Any bleeding from the genitals during pregnancy should be evaluated, no matter the amount.
• Fluid leakage — Y ñehe: Fluid coming from the genitals that soaks your underwear and can't be held back.
• High blood pressure / severe headache — Ipresión ojupipe: A strong, persistent headache that doesn't improve, together with elevated blood pressure.
• Seeing little lights, spots or blurred vision (scotomas): Sudden changes in vision. Together with headache and swelling, these are the preeclampsia warning signs that shouldn't be ignored.
• Sudden swelling (edema) — Irurupa: Swelling that appears suddenly in the face, hands or legs.
• Severe pain in the pit of the stomach (epigastric pain): Intense pain in the upper abdomen, below the breastbone, or strong, continuous abdominal pain.
• Seizures — Ataque: Involuntary body movements or loss of consciousness. This is an emergency.
• Fever — Akãnundu: Elevated temperature, with or without chills, burning when urinating, or foul-smelling discharge.
• Severe nausea and vomiting — Py'a va'i: Vomiting that keeps you from keeping down food or fluids, with weight loss or severe weakness.
• Intense itching on the palms and soles: Strong itching, especially at night and without a skin rash, on the hands and feet: it's monitored because it can be cholestasis of pregnancy.
• The baby isn't moving or is moving less than usual — La che bebe no myiri: A clear change in the movements you already know from your baby, or several hours without feeling them. Use the fetal movement counter in this same section.
• Frequent or painful contractions before term: Contractions that repeat and hurt before 37 weeks, or that don't ease with rest. Use the contraction counter in this same section.

15 · Support and legal notice

Write to us at drverasalerno@gmail.com with any question, issue with your key, or suggestion.

• You can also write to us from the App: More → Contact has a message inbox; we get the alert and reply to the email you leave.
• If you lost your key, your PIN, or changed phones, tell us the email you purchased with and we'll sort it out.