Family Team News

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Wednesday, January 20, 2016

What you need to know about birth defects

Every 4 ½ minutes in the US, a baby is born with a birth defect. That means that nearly 120,000 (or 1 in every 33) babies are affected by birth defects each year. They are a leading cause of death in the first year of life, causing one in every five infant deaths and they lead to $2.6 billion per year in hospital costs alone in the United States.

What are birth defects?

Birth defects are health conditions that are present at birth. They change the shape or function of one or more parts of the body and can affect any part of the body (such as the heart, brain, foot, etc). They may affect how the body looks, works, or both.

There are thousands of different birth defects and they can be very mild or very severe. Some do not require any treatment, while others may require surgery or lifelong medical interventions.

What causes birth defects?

We know what causes certain birth defects. For instance, drinking alcohol while you are pregnant can cause your baby to be born with  physical birth defects and mental impairment. And genetic conditions, such as cystic fibrosis or sickle cell disease, are the result of inheriting a mutation (change) in a single gene. However, we do not know what causes the majority of birth defects. In most cases, it is a number of complex factors. The interaction of multiple genes, personal behaviors, and our environment all may all play a role.

Can we prevent birth defects?

Most birth defects cannot be prevented. But there are some things that a woman can do before and during pregnancy to increase her chance of having a healthy baby:

  • See your healthcare provider before pregnancy and start prenatal care as soon as you think you’re pregnant.
  • Get 400 micrograms (mcg) of folic acid every day. Folic acid reduces the chance of having a baby with a neural tube defect.
  • Avoid alcohol, cigarettes, and “street” drugs.
  • Talk to your provider about any medications you are taking, including prescription and over-the-counter medications and any dietary or herbal supplements. Talk to your provider before you start or stop taking any type of medications.
  • Prevent infections during pregnancy. Wash your hands and make sure your vaccinations are up to date.
  • Make sure chronic medical conditions are under control, before pregnancy. Some conditions, like diabetes and obesity, may increase the risk for birth defects.
  • Learn about your family health history.

Have questions? Email us at AskUs@marchofdimes.org.

Monday, January 4, 2016

Antidepressant use and the risk of ASD

A new study suggests that the use of antidepressants during pregnancy, specifically in the second and third trimesters, may increase the risk of autism spectrum disorder (ASD) in children.

While these findings help to add to our understanding of autism, it is important to recognize that this study does not prove that antidepressant use causes autism. It is difficult to determine whether the increased risk of ASD is the result of antidepressants or the result of the underlying depression.

Researchers looked at data from more than 145,000 births between 1998-2009. They found that when mothers took antidepressants during the second and third trimesters, the chance that the child would develop ASD was higher when compared to children whose mothers did not take antidepressants. Keep in mind that the overall risk of having a child with autism is 1%. This study suggests that the risk increases to 1.87% if a woman is taking certain antidepressants.

The increase was seen with a specific type of antidepressants called selective serotonin reuptake inhibitors (SSRIs). SSRIs are the most commonly prescribed antidepressant medicines and include medications like citalopram (Celexa®), escitalopram (Lexapro®), fluoxetine (Prozac®), paroxetine (Paxil®) and sertraline (Zoloft®).

There are a number of causes of ASD but we don’t know all of them. More research is needed. However, there are some factors that we know increase the chance of ASD:

  • Having pregnancy complications. Some research shows that there may be a link between ASD and pregnancy complications that lead to low birthweight, premature birth or cesarean birth.
  • Taking certain prescription medicines, like valproic acid or thalidomide, during pregnancy. Taking these medicines during pregnancy has been linked with a higher risk of having a child with ASD.
  • Having an older parent. Babies born to older parents are more likely to have ASD.
  • Having genes linked to ASD. Researchers are studying a number of genes that may be linked to ASD. Children who have a brother or sister with ASD are more likely to have ASD themselves.
  • Having a genetic or chromosomal condition. ASD happens more often in children who also have certain genetic or chromosomal conditions, like fragile X syndrome or tuberous sclerosis.

Important:  If you are pregnant or thinking about getting pregnant and are taking antidepressants, you should not stop taking them until you talk to your health care provider. Together you can look at the possible risks of these drugs on your baby as well as the risk of having your depression come back if you stop taking your medicine. Learn as much as you can about the medicines so you can make the best choice for you and your baby.

Have questions? Email us at AskUs@marchofdimes.org.


 

Monday, December 21, 2015

E-cigarettes and pregnancy

Electronic cigarettes (also called e-cigarettes) look like regular cigarettes. But instead of lighting them, they run on batteries. They create a mist that you inhale, and they contain nicotine in a liquid form.

Are e-cigarettes safe to use during pregnancy?

We know that:

  • No amount of nicotine has been proven safe in pregnancy.
  • No studies have been done on the safety of e-cigarettes in pregnant women or on whether they help pregnant women stop smoking.
  • Use of other nicotine-containing products during pregnancy, such as smokeless tobacco, is associated with lower birth weight, increased stillbirth rates, and premature birth.

Liquid nicotine poisoning

Liquid nicotine for e-cigarettes is sold in small tubes that may be bright and colorful. They may have flavors, like cherry or bubble gum. All of these things may make them seem fun and appealing, especially to children. Liquid nicotine has powerful toxins and a small amount may be very harmful, even deadly. It can cause nausea (feeling sick to your stomach), vomiting, and eye irritation.

There have been many reports of people, especially children, being poisoned from coming into contact with liquid nicotine, either by accidentally drinking it or by spilling it and absorbing it through the skin. According to the CDC, e-cigarette exposure calls to poison centers increased from one per month in September 2010 to 215 per month in February 2014, and over half of those calls were regarding children ages 5 and under.

Regulation and research

E-cigarettes are not currently regulated by the Food and Drug Administration (FDA), although this may change soon.

More research is needed to better understand the effects of e-cigarettes on women during pregnancy and their children. If you’re pregnant and using e-cigarettes or thinking about using e-cigarettes, talk to your provider.

Have questions? Email us at AskUs@marchofdimes.org.

Wednesday, December 16, 2015

Can you turn a breech baby?

You may have heard recently about a technique that can be used to “flip” a breech baby. This procedure is called external cephalic version (ECV) and is done by your prenatal care provider.

When is a baby breech?

As your due date approaches, your baby usually moves into a head down position. During a vaginal delivery, this means that the baby’s head comes out first. But in about 3-4% of full-term births, the baby doesn’t move into a head-down position. This is called a “breech presentation.” A breech baby can be positioned so that the baby’s bottom, feet, or both are facing down.

What is ECV?

Since it is best for your baby to be in a head down position for a vaginal delivery, if the baby is breech, a C-section may be medically indicated. To improve your chances of giving birth vaginally, your provider may decide to perform an external cephalic version. According to the American Congress of Obstetricians and Gynecologists (ACOG) “external cephalic version (ECV) is an attempt to turn the baby so that he or she is head down.”

Your health care provider may attempt an ECV when you are between 36-38 weeks of pregnancy. He or she will apply firm pressure on the outside of your belly to try to get the baby to roll into a head-down position. Two people may be needed to do this and ultrasound may be used to help guide the turning.

When is ECV not safe?

An ECV will not be attempted if:

  • You are pregnant with more than one baby
  • There are concerns about the health of the baby
  • You have certain uterine or cervical problems
  • The placenta is in the wrong place or has detached from the wall of the uterus (placental abruption)

Can complications occur with ECV?

ECV typically takes place in the hospital in case complications arise.  The baby’s heart rate will be monitored both before and after the procedure.  Some problems that may occur with an ECV include:


ACOG states that over 50% of all ECV attempts are successful. However sometimes the baby moves back into a breech position. While ECV can be tried again, it gets more difficult as the baby gets bigger.

If your baby is in a breech position, talk to your health care provider. You can discuss if you are a candidate for ECV as well as what delivery options may be best for you.

Have questions? Email us at AskUs@marchofdimes.org.
Tags: ACOG, breech, C-section, c-section for medical reasons, external cephalic version

Monday, December 14, 2015

The holidays are here…


Besides the usual stress of pregnancy and getting ready for your baby, the holidays often add more pressure, which can take a toll on your health. Feeling stressed is common during pregnancy, but too much can make you have trouble sleeping, have headaches or lose your appetite. High levels of stress that continue for a long time may cause health problems like high blood pressure, which can increase the chances of having a premature baby.

December is a very busy time: there are friends and families to see, holiday gatherings to attend, meals to cook, and gifts to buy. So much to do! During this time, remember to take care of yourself: breathe deeply, relax and concentrate on your pregnancy.

Here are some tips:

  • Keep moving. Exercise can help reduce your stress and prevent pregnancy discomforts. If you are shopping for gifts, walk an extra loop around the mall before you head out to your car. Park further away in the parking lot (this way you can also avoid some of the traffic of shoppers trying to park close to the mall entrance).
  • Holidays are a time for delicious desserts and heavy meals. Before you sit down and indulge in your family dinner, eat a healthy breakfast and lunch earlier in the day.
  • Extra sleep is important during this time, but taking breaks is just as important. If you have some free time between wrapping gifts, put your feet up, read a book or magazine, or watch a favorite TV show. Even just a 15 minute break can help you relax before your next task.
  • Ask for help. Holidays are a time of giving, but also receiving. Accept help when a friend or family member offers and ask for help when you are feeling tired or overwhelmed.
  • Cut back on activities you don’t need to do. Instead of spending time making a holiday dessert, why not have your favorite bakery do it for you?

Holidays can be stressful, but remember to take time for yourself.

Have questions? Email AskUs@marchofdimes.org

Wednesday, December 9, 2015

Holidays & your child with special needs- tips for the NICU, visiting Santa, dinners & traveling

From spending holidays in the NICU, finding developmentally appropriate toys, eating at Grandma’s house (without a meltdown!), to visiting Santa in a loud, bright mall, the holidays can be oh so hard for a child with special needs. Here is a walk down blog post memory lane to help you get through the next few weeks and even have some fun.


We wish you a stress-free, calm, smooth holiday season. If you have any tips that have worked for you, please share them! You can find more posts on parenting a child with special needs, here.

Questions? Send them to AskUs@marchofdimes.org.

 

Monday, December 7, 2015

Hearing loss in babies


Hearing impairment is the decreased ability to hear and discriminate among sounds. It is one of the most common birth defects.

We’re not sure what causes hearing loss in babies. Some possible causes are genetics (if you or your partner has a family history of hearing loss), viruses and infections during pregnancy, premature birth, low birthweight (less than 5.8 pounds), and infections after birth.

There are degrees of hearing loss, too. A baby can have mild, severe or complete hearing loss. Other times a child can hear but the sounds are garbled. Hearing loss is a common birth defect affecting 12,000 babies in the U.S. each year (nearly 3 in 1,000). If a child can’t hear properly, he may have trouble learning to talk.
Newborn screening

Ideally, your baby should have his hearing tested as part of the newborn screening tests which are done in the hospital after your baby is born. The CDC recommends that all babies be screened for hearing impairment before 1 month of age. Language and communication develop rapidly during the first 2 to 3 years of life, and undetected hearing impairment can lead to delays in developing these skills. Without newborn screening, children with hearing impairment often are not diagnosed until 2 to 3 years of age. By then, they have lost precious time to develop speaking skills. A timely diagnosis is important!

Getting help

If you have any concerns about your child’s hearing, don’t wait – have a conversation with his healthcare provider (a pediatrician or nurse practitioner). Here are other options:

  • Every state has an Early Hearing Detection and Intervention (EHDI) program. You can click here or call 1-800-CDC-INFO to locate your local EHDI program for services and information.
  • The CDC’s National Center on Birth Defects and Developmental Disabilities has a website on hearing loss in children, with specific pages for families, health care providers and others. The site contains information on prevention, signs and symptoms, screening and diagnosis, treatment of hearing loss, as well as statistical data on hearing loss. If you have any concerns about your child, start with the “Basics” and “Treatments” sections.
  • Additional resources and support networks related to hearing impairment and deaf children can be found here.
  • If your baby has a hearing impairment,  he may benefit from early intervention services, such as speech therapy. Learn how to access early intervention services in your area.

Bottom line

If your child has been diagnosed with hearing loss, getting help early is very important – preferably before 6 months of age.

Have questions: Text or email us at AskUs@marchofdimes.org.

Photo credit:  Baby’s First Test

Wednesday, December 2, 2015

Need to catch up on your zzzz’s?

Your baby hasn’t arrived yet, so why is it so hard to get enough sleep? Getting up to go to the bathroom, heartburn and having to adjust pillows to find a comfortable sleep position are just a few of the discomforts of pregnancy.
If you’re like me, you may have spent most of your life sleeping on your back. But now that you’re pregnant, you need to adjust to sleeping on your side. The issue with lying on your back during pregnancy is that the weight of your uterus can flatten a major blood vessel that carries blood between your lower body and heart. It is better to lie on your side, especially the left side, which will promote circulation and help reduce swelling in your feet.

So how can you catch up on your sleep?

  • Reduce your stress before bedtime – try breathing deeply, closing your eyes or relaxing in your favorite armchair before bed. You can take a warm shower or bath before bedtime too.
  • Use pillows: between your legs, to support your back and abdomen, and to lift up your upper body if you suffer from shortness of breath.
  • Use your bed only for sleep- don’t watch TV or use your iPad while in bed. Keep the room at a comfortable temperature and try using a noise machine to block out other sounds.
  • Go to bed earlier – you need as much rest as possible.
  • Avoid drinking fluids right before bedtime. If you suffer from heartburn, try to eat your last meal a few hours before going to sleep.
  • Exercising during the day can help you get a better night’s sleep, but don’t exercise too close to bedtime or it may make it hard for you to fall asleep. Read about our tips to stay active.

Your baby will be here before you know it. Take this time to grab a few extra zzzz’s whenever possible.

Have questions? Email us at AskUs@marchofdimes.org.

Monday, November 30, 2015

Is donor milk right for your preemie?

For premature babies, breast milk can be lifesaving. It is more easily digested and provides protection against many diseases. Providing breast milk, however, can be a challenge for some moms. Many moms are not able to provide their baby with their own breast milk for various reasons, they:

  • are recovering from surgery or have certain medical conditions that make it difficult to initiate and maintain a milk supply;
  • find it difficult to pump enough milk to meet their baby’s needs;
  • have chronic conditions and need to take medications that may make their breast milk unsafe.

In these cases, donor milk may be the best option for your preemie, and a better alternative to formula.

What is donor milk and where does it come from?

A milk bank is a service that collects, screens, processes and distributes safe human milk to babies in need. All donated milk goes through a pasteurization process to eliminate bacteria while keeping the milk’s essential nutrients. The milk is then packaged, stored and ready to ship to hospitals or individual recipients at home. Lactating women who wish to donate their breast milk may do so through a milk bank.

Does your preemie need donor milk?

The nutritional needs of each baby depends on many different factors. It’s important to talk to your baby’s doctor to see if donor milk is right for your baby. Some hospitals have their own donor milk bank or have a partnership with a milk bank near them. If your baby’s doctor indicates that your baby will benefit from donor milk, he can write a prescription. For more information about the milk bank closest to you, visit the Human Milk Banking Association of North America.

Can you buy breast milk from another mom who has milk to spare?

There are risks with getting breast milk from a stranger or a friend; this milk is not tested or screened for infectious diseases or contamination. A study published in the American Academy of Pediatrics showed that out of 101 samples of milk purchased online from different mothers, 74% of samples were contaminated with bacteria and 21% of samples contained cytomegalovirus (CMV) bacteria.

It’s important to be informed when making feeding decisions for your preemie. If you have any questions about donor milk or your baby’s nutritional needs, speak with your baby’s healthcare provider.