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Advice

  • Are Your Baby and Maternity Clothes Really Clean?

    We all know that once you become a parent your laundry volume goes through the roof. Even pregnancy seems to be a precursor for the greater amount of laundry with maternity clothes generally being larger then our pre-pregnancy wardrobe and more frequent wardrobe changes. More body temperature changes and generally running at a higher temperature leads to increased sweating and often greater body discomfort (or fussiness with the way our clothes look on our changing body) which all lead to our laundry bins filling up quicker.

    Taking care of a newborn just adds to the laundry pile with babies spitting up on their clothes, blowing out diapers, drooling and generally getting messy as they begin to crawl. Also we all know it is fun to change those cute baby clothes several times a day and show off our newborn in cute clean clothes to friends and family. It can often feel like we are raising a movie star as we shuffle our baby through multiple wardrobe changes gifted from baby showers before they outgrow the outfits in the next week.

    As every new mom knows, staying ahead of the laundry can quickly become a fulltime job that never seems to end. If you are like me and most moms out there you probably feel just putting the clothes through the laundry machine with the right amount of detergent is getting them clean. You are also probably patting yourself on the back when you finally get through the overflowing bin of dirty clothes and have returned them nicely folded to the respective shelves and drawers.

    It seems we are mistaken. Recent research by the American Cleaning Institute (ACI) indicates that we may not be doing the laundry right. If we are using cold water with antibacterial detergent we are not getting our clothes as clean as we think. We are in fact putting dirty clothes right back on our body and even worse, on our babies.
    First when it comes to the water temperature we are washing our clothes in, we need to go hotter. “If you’re putting clothes in cold water, you aren’t getting rid of bacteria,” Marcelle Pick, an ob-gyn and pediatric nurse practitioner at the Women to Women health care center in Yarmouth, Maine says. “For babies, their clothes tend to be more contaminated, so you should definitely wash using hotter temperatures.”

    Cute onesies and adorable stuffed animals may look clean and you may hesitate to inflict a hot water machine wash on them, but there’s a good chance that they contain bacteria (and often the really bad kind, from feces). Of course you cannot throw all stuffed animals in the wash, but at least wipe with warm soapy water and make sure they thoroughly dry before you hand them back to your baby to cuddle.
    According to the ACI’s recommendations for laundry procedures, cold water can be used to presoak items that have been heavily soiled (especially of the pee and poop variety). However we should use hot water in addition to detergent and bleach, if necessary, to thoroughly sanitize and disinfect dirty laundry.

    The second step is using an effective detergent. Ed Osann from the Natural Resources Defense Council (NRDC) senior water policy analyst, explains, “Warm or even hot water is not hot enough to sterilize clothes exposed to fecal matter. If detergent is formulated for comparable effectiveness in cold water, then no extra benefit would be expected from warm water use.”
    Contrary to what many of us would consider common sense, Osann advised avoiding antibacterial detergents as they actually promote growth of resistant bacteria. He also recommended thoroughly drying clothes in the dryer.

    How frequently should we wash our clothing? It depends on what it is. The ACI recommends washing clothes more frequently that are tighter fitting and more likely to carry more bacteria. In our baby’s case, that would be just about everything but jackets, extra layer sweaters or flowy dresses that are not soiled. For ourselves and older children, items like underwear, socks, tanks and T-shirts, tights and even jeggings should be cleaned after each wear. Other items such as jeans and khakis can get 3-4 wears before they need to be cleaned. Towels should be hung to dry after each use and should also be washed every 3-4 days, especially if they are used by kids. Bed sheets should be washed at least every two weeks and more frequently if you sweat a lot, which is common during pregnancy and postpartum.

    The next step is maintaining a clean washing and dryer by setting up a regular sanitizing routine. Clothes will get only as clean as the machine allows. Every week, or more if you do tons of laundry, you should run an empty cycle with your washer using hot water along with bleach and detergent to disinfect the washer (some washing machines have a sanitizing cycle labeled on the machine). Next be sure to run an extra rinse cycle to make sure the bleach is completely flushed out. After that it is a good idea to start off by washing your whites with hot water and detergent as there still may be some bleach remaining in the machine from disinfecting. After washing, dry your whites on high for 45 minutes to sanitize your dryer. This way your laundry machine and dryer are sanitized for the rest of your laundry.

    When the weather is nice and sunny, you can be more eco-friendly approach to save energy by washing in warm water and line-drying in the sun. The good news is that as your children get older and out of diapers, there are less of the particularly bad bacteria types to contend with, so washing in warm water may do the trick most of the time.

    Remember husbands and older kids can do the laundry too, so don’t hesitate to train as needed and delegate. Just make sure they know the laundry for optimal cleanliness.

  • Light During Pregnancy Is Important For Fetal Eye Development

    A fascinating new study of mice during pregnancy, leads evidence that pregnant humans also need light during pregnancy to aid in proper fetal eye development.

    A new study conducted by scientists from Cincinnati’s Children’s Hospital Medical Center and the University of California, San Francisco (UCSF) and recently published in the journal Nature, reveals information about the importance of sunlight during pregnancy for the eyesight of babies that are born prematurely. The study concluded that the eye, which requires light in order to see, also needs light to develop normally during pregnancy.

    Co-author Richard Lang, PhD, a researcher in the Division of Pediatric Ophthalmology at Cincinnati Children's Hospital Medical Center said:

    "This fundamentally changes our understanding of how the retina develops. We have identified a light-response pathway that controls the number of retinal neurons. This has downstream effects on developing vasculature in the eye and is important because several major eye diseases are vascular diseases."

    Lang collaborated with David Copenhagen, PhD, a scientist in the departments of Opthalmology and Physiology at UCSF. Mouse models were used in their study which produced surprising outcomes:

    Copenhagen commented, "Several stages of mouse eye development occur after birth. Because of this, we had always assumed that if light played a role in the development of the eye, it would also happen only after birth."

    The researchers in the current study revealed that the activation of the newly labeled light-response pathway must occur during pregnancy in order to achieve the precisely planned program that creates a normal eye. They point out that it is crucial for the right number of photons to reach the mother's body by late term pregnancy.

    The team of scientists completed several experiments using laboratory mouse models that let them look at the light-response pathway's purpose and parts. Mice were raised in darkness, and in a regular day-night cycle starting at late term pregnancy to examine the comparative outcomes on vascular progression of the eye.

    The scientists confirmed the purpose of the light response pathway by changing an opsin gene in mice known as Opn4 that creates melanopsin which stops the initiation of the photo pigment.

    The melanopsin protein is there in both humans and mice during pregnancy. The authors say they will continue to examine how the light-response pathway might impact the probability of pre-term babies developing retinopathy of prematurity and its relatedness to other eye conditions.

    So get outside and into the sunlight during your pregnancy as much as possible on a regular basis. The natural light not only helps your mood but is essential for your baby’s healthy eye development!

  • Learning To Say “NO”, Everyone Mom and Expecting Mom’s Right and Prerogative!

    This week I was out sick with some version of the flu. Admittedly I got a flu shot a few months ago, so I’m not positive it was the flu, but it was not pleasant and had me coughing and sneezing in my bed for most of the week. I can only imagine that it would have been ten times worse if I had not gotten the flu shot. So at this point I am at a loss with how to qualify it, do I say “I have the flu” and provoke everyone’s sympathy and judgment (for assuming I did not get a flu shot) or just go with the generic “I’m sick” description to include any and everything and maybe leave some doubt as to how sick I truly am. The short and long of it is that I am really sick and should not be around the general public coughing and sneezing involuntarily and generally spreading my germs to innocent children, parents, preschool teachers and strangers alike.

    I did find, however, there is a silver lining in this yucky sinus infection I am a victim to. That lining revealed itself with a “get out of jail free” card that I have been using like a madwomen on every single engagement and activity I have been assigned to this week. It has been nice to “just say no” and have no guilt for an entire week of getting out of an overbooked schedule of school volunteering, carpooling, field trips, gym classes, and even social engagements with friends. With the exception of getting my kids out the door in the morning to their respective schools and preschools and aiding with their homework and dinners in the evening, I largely have been at my own disposal for most of the week which has been nothing short of lovely. My husband has pitched in more to let me grab an extra 15 minutes or so of sleep in the morning. He has helped with my 4 year old’s transportation to preschool by re-arranging his business meetings. I opted out of the fieldtrip to the library, lunch with a friend, my scheduled workout at the gym, my hosting of a dinner with friends, a design meeting to redo my bathroom, volunteer ski coaching this weekend and some other volunteering at the school and church. Instead I have enjoyed some much needed time alone to read the news, a novel, a few self help books that I find interesting and insightful, some time to shop online for much needed furniture for the house and a great excuse to go to bed an hour earlier. Even my babysitter the other day took pity on me to do the extra dishes in the sink and vacuum all the kids’ rooms. Overall it’s been a pretty good deal. My mother even called worried about me and telling me “to get to the doctor right away!” I didn’t get to the doctor but I drank in the extra maternal attention and felt loved like child. Just this morning I felt like a real hero trudging to the bus stop with my kids. Wrapped in extra layers of clothes, hair array and clutching tissues in my hand, I greeted my fellow moms with my red nose and rasping voice, evoking sympathy and support from my neighbors for my mere effort of leaving my bed to accompany my kids out the door.

    As a result of this greater restfulness and empowerment to make my own choices of spending time to recuperate I have felt like a better person and a better mom, more grounded than ever before. Why isn’t life always like this? Apart from the annoying hacking cough and nose drops throughout the night so I could breathe, it’s nice feeling more cared for and generally getting out of an overbooked schedule. It’s also nice to do this without feeling any major guilt, my main culprit in life since being a fulltime mom to three little ones and quitting my corporate job.

    My take-away from this experience is that life goes on without me. I am needed and loved for what I can do and the relationships I have, but sometimes I overvalue my importance. I mistakenly feel that if I’m not fully present and perfect for every last demand made on my time, the whole world will collapse and my kids will suffer. The truth is that my kids learn a little more self-reliance when I am not 100% well and present in their lives and a little failure on their part, like forgetting to finish all their homework or practice their piano one week, may result in a lesson well learned- that of learning the ramifications of not doing their part and getting a bad grade or feeling embarrassed for not being prepared for class or a music lesson. The stakes are not high now, they are in elementary school and they can afford a few failures that may protect them from greater failures down the road when they do not have their mom hovering over them to assure they fail at nothing at all.

    I also learned that saying “no” is very empowering. As a mom I often forget that “no” is even an option. Also, since I quit my fulltime demanding corporate job and work for myself , I often feel that I am at everyone’s disposal – any class that needs a last minute volunteer, that’s me. If the 3rd grade teacher needs an extra parent for the field trip, I’m there. If my friend needs me to carpool last minute and take her daughter across town to a girl’s scout meeting in the evening that’s totally inconvenient to my Friday night, sure I can do that! (We’ll just eat dinner a little later!) If my son’s preschool teacher needs someone to pitch in last minute for snack day, I can do it! In order to prove myself the ever mighty mom and community helper, I am generally at anyone’s disposal anytime of the day or week. Being sick has forced me to say “no” and surprisingly no one is angry about it, in fact they are quite sympathetic and caring about my condition. I can really lounge in bed all day and feel good about it. I just got my first full night’s sleep in over a year the other night as I woke up feeling slightly better. Then I thought, “oh no”, I’ll need to go to that PTC at the school tomorrow night and cook for that homeowner’s potluck on Saturday. Maybe I’m still sick enough to stay home?

    I now realize how silly this all is. Does it really take coming down with the flu where I am not physically able to do as much to figure out that “no” is a word we are all capable of using when we need to/want to. Although it is good and admirable to pitch in over and beyond the call of duty now and then, it should not be a habit. Just being a mom is going beyond the call of duty every single day and just because we don’t get a paycheck or a pat on the back for that all consuming, most important job in the world, does not mean we don’t get to say “no” when we feel like it and take time out to refuel before we really are physically sick and emotionally drained. “No” is a privilege and a right we should remember to employ anytime we need to as it will allow us to draw boundaries to protect ourselves and make our own voluntary decisions more wholeheartedly. It also allows our “yeses” to be more real, more enjoyed and more purposeful. Yes, we do still have the right to choose what we do and don’t want to do, just maybe not when it comes to helping our kid in the bathroom!

    Pregnancy is great time to gain experience at saying “no” if that’s something you need a little more practice at doing. Pregnancy affords you all kinds of luxuries you can and should take advantage of – like a more doting partner, unfamiliar men opening doors for you and giving up their bus seats. Morning sickness is no picnic, but it does afford you the right to say “no” to your well meaning family members who want you to attend a certain family wedding across the country or participate in the weekly family potluck. It even allows you the privilege of saying “no” to your employer regarding working overtime, travel or working at all. You have your doctor’s permission if need be to enforce that “no” to guard your health and that of your developing baby’s. Believe me, those “no’s” are worthwhile and will be excellent practice for you when you are a mom and find yourself becoming a professional juggler more often than not. If you want to be a really good mom, learn your “nos” now and make it a useful word in your vocabulary. Your friends and loved ones may be a little shocked at first if they are not used to hearing you say it, but it gets easier over time for them and you. My 4 year old knows about this magic word already and I guess he sees it works for him from time to time as he keeps using it unabashedly, maybe I should take some lessons from him!

  • Sex while pregnant is generally safe

     

    Research has shown that having sex while pregnant is generally safe.

    Published in the Canadian Medical Association Journal, the study showed that there are few complications involved in the practice.

    Using current evidence, the team from Mount Sinai Hospital and the University of Toronto explained that the uncommon, but potential, risks involved in sex in pregnancy include premature labour, pelvic inflammatory disease, haemorrhage in placenta previa and blood clots.

    Dr Clare Jones and her co-authors wrote: "Sex in pregnancy is normal.

    "There are very few proven contraindications and risks to intercourse in low-risk pregnancies, and therefore these patients should be reassured.

    "In pregnancies complicated by placenta previa or an increased risk of preterm labour, the evidence to support abstinence is lacking, but it is a reasonable benign recommendation given the theoretical catastrophic consequences."

    They concluded that comfort level and readiness to engage in sexual activity should be used as guides by the couple involved.

  • Why the health of pregnant women matters to us all

    By Annie Murphy Paul,author of "Origins: How the Nine Months Before Birth Shape the Rest of Our Lives."

    "Pregnant Is the New Sexy," read the T-shirt a friend gave me when I was a few weeks away from my due date. With my swollen ankles and waddling walk, I wasn't so sure - but it's hard to deny that pregnancy has become rather chic. Glossy magazines flaunt actresses' and models' rounded, half-clad bellies on their covers. Inside they chronicle celebrities' pregnancies in breathless detail, from the first "bump" sighting to the second-trimester weight gain to the baby-gear shopping spree. And now comes the news that "What to Expect When You're Expecting" - the advice bible that has sold more than 14 million copies - will be made into a feature film.

    There's something wrong with this picture. Even as Americans fuel a rapidly growing pregnancy industry of designer maternity jeans and artsy pregnancy portraits, we're ignoring the real news about these nine months. An emerging science known as the developmental origins of health and disease - DOHaD for short - is revealing that the conditions we encounter in the womb can have a lifelong impact on our health and well-being, affecting everything from our appetite and metabolism to our susceptibility to disease to our intelligence and temperament.

    The more we learn about these effects, the clearer it becomes that investing in maternal health would return larger and longer-lasting dividends than almost any other comparable public health investment. But as a nation, we're heading in exactly the opposite direction, spending more and more of our limited resources on the later stages of life instead of where they can make the most difference: at the very beginning.

    Take obesity. Many anti-obesity initiatives concentrate on changing adults' behavior, trying to persuade us to eat less and exercise more. But research shows that these efforts have limited effectiveness. A recent analysis of U.S. obesity-prevention campaigns, conducted by Olaf Werder of the University of New Mexico, concluded that their "overall impact on obesity has been negligible."

    Even public health programs aimed at school-age children come too late: Almost a third of American children over age 2are already overweight or obese, according to the National Health and Nutrition Examination Survey. Clearly, the conditions that contribute to obesity must begin exerting their influence very early in children's lives - as early as their time in the womb.

    DOHaD research shows that the intrauterine environment of a woman who is significantly overweight when she conceives - or who puts on excessive weight during pregnancy - affects the developing fetus in ways that make it more likely to become overweight itself one day. Scientists are still figuring out exactly why this happens, but it appears that prenatal experience may alter the functioning of organs such as the heart and the pancreas, may shift the proportion of lean and fat body mass, and may influence the brain circuits that regulate appetite and metabolism.

    In a cleverly designed study published in the Journal of Clinical Endocrinology and Metabolism in 2009, researchers compared children born to the same mothers before and after they'd had successful anti-obesity surgery. Children born after their mothers' surgery weighed less at birth and were three times less likely to become severely obese than their older brothers and sisters. Weight-loss surgery isn't for everyone, of course. Still, what if before conceiving, overweight women were routinely counseled by their doctors about the effects of their weight on future offspring? And what if women who were gaining weight too rapidly in pregnancy were offered more help in controlling it?

    The results might look something like those found in studies of diabetes treatment during pregnancy. Research shows that the children of diabetic women are more likely than others to develop diabetes - in one recent study, seven times more likely. Like obesity, diabetes has a strong genetic component, but scientists are also beginning to focus on the effects of a diabetic intrauterine environment. For example, a long-running study of the Pima Indians of Arizona, who have one of the highest rates of diabetes in the world, concluded that exposure to the disease while in the womb was responsible for about 40 percent of the diabetes cases studied.

    A pregnant woman's diabetes can also affect the odds that her child will become obese. In a study of almost 10,000 mother-child pairs, researchers from the Center for Health Research at Kaiser Permanente Northwest found that women who developed diabetes during pregnancy and were not treated had children who were twice as likely to become obese as the children of women without that illness. Pregnant women whose diabetes was treated with insulin, however, had children with no additional risk of obesity. Simply by controlling their mothers' blood sugar during pregnancy, in other words, the expected doubling of these children's obesity risk was completely reversed.

    Even the mental health of a pregnant woman can have a long-term impact on her offspring. A 2008 study by researchers at the Kaiser Permanente Oakland Medical Center in California found that women with even mild symptoms of depression are 60 percent more likely to deliver early than other women; those who are severely depressed have double the risk of premature birth. The babies of depressed women are also more likely to have low birth weight, to be irritable and to have trouble sleeping.

    Of course, these complications may come about in part because many depressed women don't take good care of themselves: They may eat poorly, smoke or drink alcohol, or fail to get prenatal care. But depression itself may shift the biochemical balance in a woman's body in a fateful manner. For one thing, the stress hormone cortisol, which is often elevated in people with depression, may cross the placenta, directly affecting fetal development, and it may also affect a pregnant woman's blood vessels, reducing the oxygen and nutrients that reach the fetus.

    The case seems pretty clear: We should make a nationwide effort to ensure that every obstetrician checks every pregnant patient's mental state, along with her weight and blood pressure. Women who show signs of depression should be offered therapy or, in cases that warrant it, carefully administered antidepressant medication.

    Adult behavior can be difficult to change, as we know from the general ineffectiveness of anti-obesity campaigns. But pregnant women are a special case: They're usually highly motivated, they're typically in regular contact with health-care providers, and they have to keep up their efforts for only nine months. Pregnancy therefore offers a singular opportunity to improve lives for decades to come, via interventions that cost little compared with the enormous price tags for obesity, diabetes, low birth weight and premature delivery.

    So why isn't this critical window one of our top health-care priorities?

    Part of the reason may simply be our preference for quick fixes and for dealing with only those problems that exist in the here and now. It can be hard to wrap our heads around the notion that a woman's diet or mental state today will have a serious effect on her children's health many years out. But there's a less obvious reason that resistance to maternal health initiatives might crop up among the liberal-leaning individuals who typically support public health initiatives and women's health-care issues: abortion politics.

    Caring for the fetus, protecting the fetus from harm - to abortion rights advocates, such measures sound like the steps antiabortion forces have taken to try to establish a fetus's rights. What's the difference between controlling a diabetic pregnant woman's blood sugar and, say, charging a pregnant woman who uses drugs with child abuse? Between telling an obese pregnant woman that her weight may predispose her child to obesity and requiring a woman to look at an ultrasound of her fetus before proceeding with an abortion?

    The crucial difference lies in the intent behind the intervention and in the way it's carried out. Help in achieving a healthy pregnancy must be offered to pregnant women, not forced upon them. And the aim behind such efforts must be to foster the health and well-being of the woman and her fetus, not to score political points.

    Ultimately, research on the developmental origins of health and disease should lead us to a new perspective on pregnancy, one that's not about coercing or controlling women - nor about ogling or fetishizing them - but about helping them, and their future children, be as healthy and as happy as they can be.

  • Painkillers in Pregnancy Linked to Male Infertility

    Study Suggests Even Tylenol During Pregnancy May Affect Male Testes

    By Daniel J. DeNoon of WebMD Health News

    Reviewed by Laura J. Martin, MD

    Common over-the-counter painkillers taken during pregnancy may be to blame for a global rise in male infertility.

    Even acetaminophen (Tylenol) may put a developing boy's future reproductive health at risk, suggest findings from a study of some 2,300 Danish and Finnish women by Henrik Leffers, MD, PhD, of Rigshospitalet, Copenhagen, Denmark, and colleagues.

    The researchers suggest that acetaminophen, ibuprofen, aspirin, and other NSAID painkillers act as hormonal "endocrine disruptors" and interfere with normal male sexual development. Chemicals in the environment, such as phthalates, act as endocrine disruptors and have in the past been blamed for harmful effects on human sexual development.

    "A single [acetaminophen] tablet (500 milligrams) contains more endocrine disruptor potency than the combined exposure to the ten most prevalent of the currently known environmental endocrine disruptors during the whole pregnancy," Leffers says in a news release.

    Despite the strong language, the researchers note that their findings are based on a small number of boys whose testicles were late to descend -- a risk factor for poor future semen quality. While they note that more study is needed, they stress the urgency of such studies.

    "Although we should be cautious about any over-extrapolation or overstatement ... the use of these compounds is, at present, the best suggestion for an exposure that can affect a large proportion of the human population," Leffers says.

    The Leffers study is based on questionnaires from the mothers of 834 Danish boys and 1,463 Finnish boys, and on interviews with the mothers of 491Danish boys (285 of whom also were among those who filled out the questionnaires). All of the boys were examined for signs of undescended testicles (congenital cryptorchidism).

    In the end, the researchers identified only 42 boys with signs of undescended testicles. Over 64% of these boys were born to mothers who took painkillers during pregnancy.

    Women who took more than one kind of mild painkiller were more than seven times more likely to have a boy with signs of undescended testicles.

    It appeared that painkillers taken during the second trimester of pregnancy were particularly risky -- increasing risk of congenital cryptorchidism by 2.3-fold.

    Nevertheless, these risks are based on very small numbers of affected boys. The vast majority of boys born to women who reported painkiller use did not have any sign of undescended testicles.

    Leffers and colleagues will continue to follow up on the boys through sexual maturity.

    Leffers' team also performed rat studies showing that acetaminophen and NSAID painkillers can affect sexual maturation.

    The Leffers study appears in the advance online edition of the journal Human Reproduction.

  • All Pregnant Women Should Get Flu Shot, Say OB-Gyns

    This from Frederik Joelving of Reuters Health

    Despite landing in the hospital more often if they catch the flu, no more than a quarter of pregnant women in the U.S. get vaccinated against it.

    That's according to the American College of Obstetricians and Gynecologists, which has issued a recommendation urging all pregnant women to get the flu shot.

    While the recommendation itself isn't new, the statement, published in the journal Obstetrics and Gynecology, adds evidence on the safety and effectiveness of the vaccine, said Dr. William M. Callaghan of the Centers for Disease Control and Prevention in Atlanta.

    He said the CDC and several medical associations back the statement, which notes that the shot not only protects the woman, but also her baby.

    Flu vaccines aren't approved by the Food and Drug Administration for infants younger than six months of age, but babies can get the protective antibodies naturally through breast milk if their mother got the vaccine.

    While some flu vaccines contain the mercury-based preservative thimerosal, a study out last week found the compound did not increase the risk of autism, as some have worried. (See Reuters Health story of September 13)

    The statement does not recommend against vaccines containing preservative, but notes that thimerosal-free alternatives are available.

    It adds that there have been no reports of side effects in pregnant women or their babies, but that women should only get the inactivated vaccine.

    Last week, the CDC asked healthcare providers to encourage pregnant women to get flu shots.

    This could have a large impact on women's decision-making, according to data from 2006 and 2007 surveys of pregnant women in Georgia and Rhode Island.

    The findings, also published in Obstetrics and Gynecology, show less than one in five women in Georgia had been vaccinated against the seasonal flu. Many of those who hadn't, said their doctors had never broached the topic.

    By contrast, nearly a third of women in Rhode Island had been vaccinated, with encouragement from a healthcare provider increasing the chances more than 50 times.

    In its letter to physicians, the CDC said pregnant women were more susceptible to severe illness caused by flu, and accounted for one in 20 deaths from H1N1 influenza (swine flu) in 2009. By comparison, only one in 100 was pregnant in the population.

    "We know for certain that there are changes in the immune system that allow the pregnancy to continue," Callaghan told Reuters Health. "Perhaps the downside is that they also allow the virus to persist."

    The U.S. flu season starts in October and lasts through May.

    Source : Obstetrics & Gynecology Journal

  • Doctors Break Down Which Pregnancy ‘Tips’ Really Matter

     

    By Matt Brennan of The Beacon-News

    While the lists of pregnancy do’s and don’ts can be extensive, there is one thing women should not lose track of as they go through the process, and that’s enjoying it.

    That’s the advice of Dr. Susan Acuna, obstetrician/gynecologist on staff with Central DuPage and Delnor Community hospitals.

    Women should remember to enjoy the experience of having a child moving around inside them, she said. While they experience that thrill, there are things they can be doing to keep themselves and the baby healthy.

    There is a lot of information out there. It can be overwhelming. Some of the information and ideas have a stronger medical basis than others. It is best to follow the recommendations that have a stronger basis in medicine and science, she said.

    “Many women come in and say, ‘I heard I should avoid lunch meat and peanut butter,’” Acuna said. “Those are not based on any factual information.”

    The concern about peanuts or peanut butter is that eating them would increase the baby’s chance of picking up the allergies. It’s not based on enough science, she said. With lunch meat, she said to just make sure that it is reasonably fresh.

    The most important thing for women to do during pregnancy is to take a prenatal vitamin, Acuna said.

    “It’s shown to prevent birth defects,” she said. “That’s an important thing that women may or may not know.”

    Provena Mercy Medical Center nutritionist Melissa Gash said that making sure calorie intake is correct for the patient’s height and weight is important.

    “You really only need about 300 extra calories a day,” she said. “It’s really minimal what you have to increase.”

    To put it in perspective, the extra calories can be achieved with a glass of milk and an apple, she said. The normal recommended weight gain during a pregnancy is about 25 to 30 pounds. Many women gain much more than that, she said.

    “They wonder why they can’t lose that weight after the baby’s out,” she said.

    Yoga, Pilates and prenatal water aerobics have all increased in popularity recently, said Dr. Natalie Roche of Fox Valley Women and Children’s Health Partners. The exercises can help to alleviate some of the pain associated with pregnancy, she said.

    There are some exercises that should be avoided during pregnancy, such as biking, roller skating and jumping on a trampoline, Acuna said.

    “I recommend they avoid any activity that would put them at risk of falling,” she said.

    Running, biking on a stationary bike and working out on an elliptical machine are all safer forms of exercise, she said.

    Gash is on her third pregnancy, she said. She also runs a nutrition seminar for pregnancy at Provena Mercy called “From Pickles to Ice Cream.” Cravings are legitimate, she said. Many pregnant women have them. But, “a lot of women use them as an excuse,” she said.

    Morning sickness and nausea are fairly common, especially during the first 12 weeks of pregnancy, she said.

    “Sometimes you’re just not going to feel that good those first couple weeks,” she said.

  • Pregnancy Problems Could Be From Antibacterial Agent

    Dr. Margaret James, professor and chair of the department of medicinal chemistry at the University of Florida, is seen here in a photo taken Oct. 26, 2010. James has found that tricolsan, an ingredient found in some of the most popular brands of antibacterial soaps, toothpaste and other household products, may disrupt an enzyme important during pregnancy. (Jesse S. Jones/University of Florida)

    A chemical found in everything from antibacterial soaps and lotions to socks and toothpaste may disrupt an enzyme that plays an important role in pregnancy, University of Florida researchers say.

    Thought to be harmless, triclosan gives many soaps and lotions their antibacterial oomph and is found in hundreds of popular products. But a team of UF researchers led by Margaret O. James has discovered that the chemical hinders an enzyme linked to the metabolism of estrogen. The researchers’ findings are reported in the November print issue of the journal Environment International.

    In pregnancy, this enzyme, called estrogen sulfotransferase, helps metabolize estrogen and move it through the placenta into the developing fetus. There, the estrogen plays a crucial role in brain development and the regulation of genes.

    “We suspect that makes this substance dangerous in pregnancy if enough of the triclosan gets through to the placenta to affect the enzyme,” said James, a professor and chairwoman of medicinal chemistry in the UF College of Pharmacy. “We know for sure it is a very potent inhibitor. What we don’t know is the kinds of levels you would have to be exposed to to see a negative effect.

    “We know it is a problem, but we don’t know how much of a problem. We need to move forward and do additional studies.”

    In pregnancy, the placenta basically serves as a developing baby’s in-womb survival kit. Almost everything the fetus gets from its mother — namely food and oxygen — comes through the placenta. It also creates important hormones, such as progesterone and estrogen.

    Aside from the role it plays in the fetus, estrogen also affects how much oxygen the baby gets from the mother, said Charles Wood, a professor and chairman of physiology and functional genomics in the UF College of Medicine and a co-author of the study. All of the oxygen a baby gets from its mother flows through the mother’s uterine artery. Without enough estrogen, this artery can constrict, decreasing blood flow.

    “If you don’t make enough estrogen you can, we think, starve the baby of enough oxygen,” Wood said.

    Estrogen is also involved in signaling the uterus to contract during labor. But maintaining the right levels of the hormone during pregnancy is a delicate balance, Wood says. Too much estrogen could send the mother’s body into premature labor. Too little could hinder the flow of oxygen. Both instances could affect how the baby’s brain develops.

    This is one of the reasons scientists are concerned about the pregnancy-related effects of chemicals such as triclosan.

    “Some of these (chemicals) can go and combine with estrogen receptors and mimic estrogen or keep estrogen off its receptors or change the metabolism of estrogen, which is what we are looking at with triclosan,” Wood said.

    In April 2010, the Food and Drug Administration decided to take a closer look at triclosan after several studies found links to problems with hormone regulation and other possible negative health effects. Other studies have shown that the chemical, which cannot be broken down by bacteria, stays in the environment long after it is used.

    “Triclosan is a material that is present in the environment and everyone has low levels. If you use products with triclosan, you will likely have higher levels,” said Bruce Hammock, a professor of entomology at the University of California-Davis who studies triclosan. “It has some real benefits but it is certainly not risk-free.”

    More studies are needed before researchers can conclude what effects triclosan really has on human health, James said.

    “The triclosan is incorporated into household products because it inhibits bacterial growth,” James said. “But the bad thing is it has this unexpected side effect of inhibiting this important enzyme in the body. At this point we don’t know if the levels people are exposed to are high enough to cause an adverse effect.”

    Source: April Frawley Birdwell, http://www.physorg.com/news/2010-11-pregnancy-problems-antibacterial-agent.html, Provided by University of Florida

  • Genetics May Play A Part In A Woman's Chance For Nausea During Pregnancy

    Researchers found that women were more likely to experience a serious form of morning sickness if their mothers or sisters did as well.

    Looking specifically at a very severe form of nausea known as hyperemesis gravidarum (HG), the authors found that women with sisters who had HG were 17 times more likely to also develop HG. Women with this condition have unrelenting, excessive nausea and vomiting that puts them at risk of malnutrition, dehydration and significant weight loss.

    Study author Dr. Marlena Fejzo of the University of Southern California-Los Angeles told Reuters Health she wasn't surprised by the findings, since previous research has shown that severe morning sickness is more likely to affect both members of identical twin pairs, hinting at a heritable element.

    However, in the new study, she added, “the degree of heredity is very exciting because it suggests genes are involved, and when we find those genes, we may finally understand the cause of severe nausea in pregnancy and be able to make new treatments that are designed to treat the cause rather than the symptoms.”

    Most pregnant women - an estimated 75 percent - experience some morning sickness, according to the American Pregnancy Association, but 1 percent suffer the extreme HG form of illness that can require hospitalization.

    It's unclear why some women become nauseous while pregnant and others don't. Even animals such as dogs and monkeys appear to experience a form of morning sickness, Fejzo noted. “There are even reports of snakes avoiding food during pregnancy,” she said in an e-mail.

    To investigate whether severe forms of nausea might have genetic roots, Fejzo and her team reviewed information collected from 207 women who experienced HG during pregnancy and had at least one sister who had also been pregnant. They compared their responses to 110 of the patients' female friends who had relatively nausea-free pregnancies, serving as controls.

    The researchers found that 14 percent of women who experienced HG during pregnancy had sisters who also had HG, versus less than 1 percent of women who did not have HG.

    When combining HG with other severe forms of morning sickness - persistent nausea that was not bad enough to require IV fluids or nutrition - a family history also appeared to put women at higher risk. Specifically, 34 percent of women with HG also had an affected sister, versus 8 percent of women who were never diagnosed with HG.

    Among 469 women with HG and 216 of their female friends, 33 percent of those with HG had a mother with severe nausea or HG as well, versus only 8 percent of their friends.

    “There can be variation in nausea and vomiting from one pregnancy to the next, which suggests that not only genes are involved but also other factors,” Fejzo noted. “For example, some studies suggest a female fetus or carrying multiple fetuses results in more nausea. So I would speculate that the level of nausea in pregnancy is a combination of both genetic factors and non-genetic factors.”

    One concern about these findings, noted Dr. Andrej Grjibovski at the Norwegian Institute of Public Health, who did not participate in the study, is that women with HG might have been more likely to volunteer to participate in the study if they had relatives who were also affected. And since these women recruited the controls themselves, they “may not be representative of the general population,” he cautioned.

    Still, Grjibovski said in an e-mail that he was “not at all” surprised by the findings, since other research has suggested both maternal and paternal genes may play a role in HG. A recent analysis of more than 2 million birth records showed that women whose mothers suffered from a serious type of morning sickness were at triple the risk of the condition themselves.

    HG hospitalizes more than 59,000 women every year in the U.S. A recent review of 27 large studies concluded that there is no reliable treatment for nausea in early pregnancy. Still, options include dietary changes (such as eating small meals and avoiding spicy foods), alternative therapies such as acupressure and hypnosis, and some prescription anti-nausea medications.

    Fejzo said her team is currently planning a study to compare the genes of 1,000 women with HG to those of 1,000 of their unaffected friends. “With this approach, we should be able to identify the genetic variants that predispose to HG and then hopefully create new, more effective medications that are designed to correct the cause of the disease as opposed to the current medicines which are used to treat the symptoms.”

    Source: American Journal of Obstetrics & Gynecology, online October 25, 2010.

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