Tag Archive for 'maternity health'

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Breastfeeding Hospital Crib Cards

Nursing Bra Tank by Bravado

I just found these really cool breastfeeding hospital crib cards from the CDC.

There is a boy breastfeeding card and a girl breastfeeding card, but they say exactly the same thing. Just the colors are different.

They point out the advantages of breastfeeding such as less chances of being overweight, fewer ear infections, less chance of diabetes, among others. They also give you the hunger cues such as hands in mouth, searching from side to side, stretching and lastly crying (which means you are late!).

The intent is for the hosiptals to put them on the cribs but you can always print one out and put it there to remind the nurses you are breastfeeding.

New Research Shows Breastfeeding Is Tied To Lower Incidence Of Asthma

If you are looking for one more reason to breastfeed your baby, consider the latest research on the link between breastfeeding and lower asthma rates in children. According to two new research reports, breastfeeding increases lung volume which makes babies and children less susceptible to get asthma.

Also, this new research found that even mothers who were asthmatic still benefited their children by breastfeeding them and thus increasing their lung volume. In the past it was thought that only asthma-free moms should breastfeed. This research shows that the babies benefited from breastfeeding whether or not the mom had asthma. (It’s suspected that the babies suckling activity when breastfeeding increases it’s lung power).

Even more significantly, these studies showed that the longer the mother exclusively breastfeed their baby, the less risk the child had of getting asthma or breathing related problems. A team led by Karen Silvers with data on more than 1000 kids found that each additional month of exclusive breastfeeding was tied to a nine percentage drop in asthma risk.

The World Health Organization recommends breastfeeding exclusively (with no formula) for the first six months of the child’s life then to continue to breastfeed (as solids are introduced) for two years or longer.

So, here’s some more reasons to breastfeed your child (particularly exclusively breastfeeding them for the first 6 months of life). Your child will reap the benefits for a lifetime.

SOURCES: bit.ly/yCsmfY American Journal of Respiratory and Critical Care Medicine, online February 3, 2012 and bit.ly/wVKRCQ Journal of Pediatrics, online January 29, 2012.

1 in 5 Canadian Women Having Babies Later In Life

The study by the Canadian Institute of Health Information notifies that one out of five babies born in Canada are of mothers who have given birth at around 35 years of age, and older.

According to the study, among babies born between 2006 and 2009, 17.9% of them were born out of mothers who were 35 or above. Also, it has been notified that the rate is highest in B. C. as compared to other provinces, as 22.3% of the babies were born to the mothers aged 35 and above.

It has also been revealed that B. C. has the highest rate of pregnant mom aged above 40, as 3.9 of the pregnant women fall in that age group.

Experts say that the women who become pregnant after 35 have twice more chances of suffering from gestational diabetes and those above 40 are thrice more likely to suffer from the ailment compared to the women who become pregnant at an early age.

Gestational diabetes results in delivery complications due to the high blood pressure condition and it can occur when pregnancy hormones obstruct the insulin from metabolizing sugar and other carbohydrates.

A study by the Canadian Institute of Health Information indicates that 20% of Canadian mothers are having babies when they are older than 35 years. British Colombia has a higher rate at 22.3% compared to the other provinces at 17.9%.

Studies have shown that women above 35 are twice as likely as other younger age groups in having gestational diabetes and women about 40 when pregnant are three times as likey.

Gestational diabetes is high blood sugar that starts or is first diagnosed during pregnancy. While there may not be any symptoms present some symptoms may include:

  • Blurred vision
  • Fatigue
  • Frequent infections, including those of the bladder, vagina, and skin
  • Increased thirst
  • Increased urination
  • Nausea and vomiting
  • Weight loss in spite of increased appetite

Most women with normal pre-natal care should receive a gestational diabetes test if they are over 35.

Pregnant Women Lie About Smoking

This article by By NICHOLAS BAKALAR of the NY Times

When pregnant women are asked if they smoke, almost a quarter of the smokers deny they have the habit. Using data from the National Health and Nutrition Examination Survey conducted from 1999 to 2006, researchers writing online in The American Journal of Epidemiology report that 13 percent of 994 pregnant women, and almost 30 percent of 3,203 nonpregnant women of reproductive age, were active smokers. (Rates among these women, 20 to 44 years old, are higher than rates for the general population of women.)

Among pregnant smokers, 23 percent reported that they did not smoke, despite high blood levels of cotinine, a biological indicator of tobacco exposure, that showed they did. More than 9 percent of the nonpregnant smokers also lied about it.

The authors acknowledge that cotinine levels can be increased by secondhand smoke, and that the exact blood level of cotinine that indicates smoking in pregnant women is not known. But pregnant women metabolize cotinine faster than nonpregnant women, so their smoking rate may actually have been underestimated.

The lead author, Patricia M. Dietz, an epidemiologist with the Centers for Disease Control and Prevention, said that the deceit probably stemmed from embarrassment. “Smoking has been stigmatized,” she said. “They feel reluctant to be chastised.” But concealing the addiction is not the answer, she said — quitting is. And, she added, “it’s never too late to quit.”

New guidance on vitamin D recommends midday sunshine

New health advice recommends short spells in the sun – without suncream and in the middle of the day.

Seven organisations have issued joint advice on vitamin D, which the body gets from natural sunlight.

The nutrient keeps bones strong, and protects against conditions like osteoporosis.

The guidance was drawn up because it is thought fears about skin cancer have made people too cautious about being in the sun.

Cancer Research UK and the National Osteoporosis Society are among the bodies which agree that “little and frequent” spells in summer sunshine several times a week can benefit your health.

The experts now say it is fine to go outside in strong sun in the middle of the day, as long as you cover up or apply sunscreen before your skin goes red.

‘Too negative’

A good diet and sensible sun exposure will be adequate for most people to minimise their cancer risk.”

End Quote Professor Peter Johnson Cancer Research UK

Professor Rona Mackie, from the British Association of Dermatologists, said: “Total sun protection with high factor suncream on all the time is not ideal, in terms of vitamin D levels.

“Even Australia has changed its policy on this. They’re now producing charts showing parts of Australia where sun protection may not be required during some parts of the year.

“Some of the messages about sun exposure have been too negative. UK summer sunshine isn’t desperately strong. We don’t have many days in the year when it is very intense.

“What’s changed is that we’re now saying that exposure of 10 to 15 minutes to the UK summer sun, without suncream, several times a week is probably a safe balance between adequate vitamin D levels and any risk of skin cancer.”

Official government advice already recommends vitamin D supplements for pregnant women and children aged under five.

But the experts who wrote the joint statement say mothers often are not made aware of this recommendation. They suggest women consult their GP.

Winter levels of vitamin D can be helped by a break in the tropical sun – or by eating oily fish, liver and fortified margarine.

‘Complex area’

Cancer Research UK’s chief clinician, Professor Peter Johnson, said: “A good diet and sensible sun exposure will be adequate for the great majority of the UK population to minimise their cancer risk.

“The area of vitamin D and cancer is complex.

“There’s some evidence, which is strongest in bowel cancer, that low levels of vitamin D in the blood correlate with the risk of developing cancer.

“But that doesn’t mean those low levels cause bowel cancer.

“We think overall that low levels of vitamin D are unlikely to be major contributors to the chances of developing cancer in the UK population.”

The joint statement also highlighted questions about vitamin D that warrant further research.

These include finding out the optimal levels of vitamin D, and more detail about the role of dietary sources and supplements.

Autism More Likely in Kids Whose Moms Live Near Freeways

Having a mother who lived within 1,000 feet of a freeway while pregnant doubles a child’s odds of having autism.

The finding comes from a study looking at environmental factors that might play a role in autism. University of Southern California researcher Heather E. Volk, PhD, MPH, and colleagues collected data from 304 California children with confirmed autism and from 259 children who developed normally.

“It has been estimated that 11% of the U.S. population lives within 100 meters [328 feet] of a four-lane highway, so a causal link to autism or other neurodevelopmental disorders would have broad public health implications,” the researchers note.

Exposure to air pollution during pregnancy is suspected of a wide range of negative effects on the fetus. A particularly crucial period may be the third trimester, when the brain develops rapidly.

Air pollution is particularly heavy within a thousand feet of a highway. Volk and colleagues found that the 10% of women who lived closest to a freeway during pregnancy were within about 1,000 feet of center line. Children born to these women were 86% more likely to have autism than kids born to women who lived farther from the freeway.

The relationship was stronger for women who lived within 1,000 feet of a freeway during their third trimester. Children born to these women were 2.2 times more likely to have autism.

Interestingly, the odds of autism remained unchanged when the researchers controlled for factors such as child gender or ethnicity, household education, maternal age, and maternal smoking.

It’s becoming clear that a child’s genetic inheritance has a lot to do with whether that child has autism. But genes do not explain why one child develops autism while another does not. Many researchers believe that something or a combination of things in the environment trigger autism in genetically susceptible kids. That exposure may come while the child is still in the womb.

But what is it about living near a freeway that might trigger autism? Is it really air pollution? Or could it be the noise?

Volk and colleagues note that their findings should be confirmed in studies that measure the actual air pollutants to which pregnant women living near freeways are exposed.

The Volk study appears in the Dec. 16 online issue of Environmental Health Perspectives, published by the U.S. National Institute of Environmental Health Sciences.

Researchers find new source of immune cells during pregnancy

This article makes for a bit harder reading but none-the-less is still interesting.

UCSF researchers have shown for the first time that the human fetal immune system arises from an entirely different source than the adult immune system, and is more likely to tolerate than fight foreign substances in its environment.

The finding could lead to a better understanding of how newborns respond to both infections and vaccines, and may explain such conundrums as why many infants of HIV-positive mothers are not infected with the disease before birth, the researchers said.

It also could help scientists better understand how childhood allergies develop, as well as how to manage adult organ transplants, the researchers said. The findings are described in the Dec. 17 issue of Science.

Until now, the fetal and infant immune system had been thought to be simply an immature form of the adult system, one that responds differently because of a lack of exposure to immune threats from the environment. The new research has unveiled an entirely different immune system in the fetus at mid-term that is derived from a completely different set of stem cells than the adult system.

“In the fetus, we found that there is an immune system whose job it is to teach the fetus to be tolerant of everything it sees, including its mother and its own organs,” said Joseph M. McCune, MD, PhD, a professor in the UCSF Division of Experimental Medicine who is a co-senior author on the paper. “After birth, a new immune system arises from a different stem cell that instead has the job of fighting everything foreign.”

The team previously had discovered that fetal immune systems are highly tolerant of cells foreign to their own bodies and hypothesized that this prevented fetuses from rejecting their mothers’ cells during pregnancy and from rejecting their own organs as they develop.

The adult immune system, by contrast, is programmed to attack anything it considers “other,” which allows the body to fight off infection, but also causes it to reject transplanted organs.

“The adult immune system’s typical role is to see something foreign and to respond by attacking and getting rid of it. The fetal system was thought in the past to fail to ‘see’ those threats, because it didn’t respond to them,” said Jeff E. Mold, first author on the paper and a postdoctoral fellow in the McCune laboratory. “What we found is that these fetal immune cells are highly prone to ‘seeing’ something foreign, but instead of attacking it, they allow the fetus to tolerate it.”

The previous studies attributed this tolerance at least in part to the extremely high percentage of “regulatory T cells”– those cells that provoke a tolerant response – in the fetal immune system. At mid-term, fetuses have roughly three times the frequency of regulatory T cells as newborns or adults, the research found.

The team set out to assess whether fetal immune cells were more likely to become regulatory T cells. They purified so-called naïve T cells – new cells never exposed to environmental assault – from mid-term fetuses and adults, and then exposed them to foreign cells. In a normal adult immune system, that would provoke an immune attack response.

They found that 70 percent of the fetal cells were activated by that exposure, compared to only 10 percent of the adult cells, refuting the notion that fetal cells don’t recognize outsiders. But of those cells that responded, twice as many of the fetal cells turned into regulatory T cells, showing that these cells are both more sensitive to stimulation and more likely to respond with tolerance, Mold said.

Researchers then sorted the cells by gene expression, expecting to see similar expression of genes in the two cell groups. In fact, they were vastly different, with thousands of genes diverging from the two cell lines. When they used blood-producing stem cells to generate new cell lines from the two groups, the same divergence occurred.

“We realized they there are in fact two blood-producing stem cells, one in the fetus that gives rise to T cells that are tolerant and another in the adult that produces T cells that attack,” Mold said.

Why that occurs, and why the immune system appears to switch over to the adult version sometime in the third trimester, remains unknown, McCune said. Further studies will attempt to determine precisely when that occurs and why, as well as whether infants are born with a range of proportions of fetal and adult immune systems – information that could change the way we vaccinate newborns or treat them for such diseases as HIV.

Tip of the Day: Pregnancy-friendly Caesar salad

This delicious article from JILL REED at the OC Register

I didn’t have too many cravings when I was pregnant with Ben.

I mostly craved salsa. Which was fine until heartburn set in during the third trimester. Then even oatmeal was painful.

But I also had a pretty consistent craving for Caesar salad. Of course, the traditional preparation with raw eggs was out of the question. And anytime I asked about it at a restaurant they said that they did indeed use raw eggs.

So I decided to experiment a bit using mayonnaise. Because of how it is processed, store-bought mayo is OK to eat if you are expecting.

I had great success. And, even though I am not pregnant anymore, I still use this recipe because it is easy and it keeps well for a few days in the fridge.

I do use anchovies in this. I know some people are not really fond of those funny little fish. I like the layer of flavor they add to a Caesar, and they get pulverized when this dressing is blended. But if they are not your thing, just leave ‘em out.

By the way, anchovies are low in mercury and high in all sorts of other good stuff. Anchovies are OK in moderation for pregnant women.

Pregnancy-friendly Caesar salad
(makes 6-8 servings, depending on how large of a salad you like)

1/4 cup extra-virgin olive oil
1/2 cup mayonnaise (I use light mayo and it works great)
4 oil-packed anchovy fillets, drained
2 tablespoons fresh lemon juice
2 large garlic cloves, coarsely chopped
1 teaspoon Dijon mustard
Freshly ground pepper
1 1/2 pounds romaine lettuce, torn into bite-size pieces
Your favorite croutons
1/4 cup freshly grated Parmesan cheese

Directions:

1. In a food processor (I use my mini processor for such a small batch) or a blender, combine the mayonnaise, anchovies, lemon juice, garlic and mustard and blend until smooth. With the processor on, slowly pour in the olive oil and blend until smooth and combined. Season the dressing with pepper to taste.

2. In a large bowl, toss the romaine with the croutons. Add the dressing and toss. Sprinkle the Parmesan over the salad, toss again and serve right away.

3. Leftover dressing will keep in the fridge for a few days. Just give it a quick whisk before you use it.

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.