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Wednesday, January 28, 2015

Painkillers and pregnancy don’t mix

Did you know that a significant number of women of childbearing age fill prescriptions for narcotic painkillers each year? If a woman becomes pregnant while taking these medications, she is at an increased risk of having a baby with birth defects.

Opioid-based (narcotic) pain medications, such as codeine, oxycodone, hydrocodone, or morphine, are used to treat moderate to severe pain. Many women are unaware that the use of these medications during pregnancy, even when used as directed, may increase their chance to have a baby with a serious birth defect of the brain, spine, or heart. They also have an increased risk of preterm birth.  Use of opioid-based painkillers during pregnancy can also cause babies to suffer withdrawal symptoms when they are born. This is a condition known as neonatal abstinence syndrome or NAS, and it is a growing problem in U.S. birthing hospitals.
A new report from the CDC found that on average, about 28% of privately insured and 39% of Medicaid-enrolled women of child-bearing age filled a prescription for an opioid between 2008-2012.

Since half of all pregnancies are unplanned, women may be prescribed opioid-based pain medications before they know they are pregnant.  “This highlights the importance of promoting safer alternative treatments, when available for women of reproductive age. We must do what we can to protect babies from exposure to opioids,” stated Coleen A. Boyle, PhD, MSHyg, Director of CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD).
“If you are using an opioid painkiller, you should also be practicing effective birth control, “ says José F. Cordero, MD, MPH, a pediatrician, birth defects expert formerly at CDC, and member of the March of Dimes Board of Trustees. “If you decide to get pregnant or do become pregnant, tell your health care provider about all the medications you are taking, right away. You may be able to switch to a safer alternative.”

The CDC’s Treating for Two: Safer Medication Use in Pregnancy initiative offers information to women and their healthcare providers about medication use during pregnancy. Go here to get more information.
Tags: birth defects, medications, narcotics, neonatal abstinence syndrome, opioids, prescription drugs

 

Breastfeeding and returning to work

My girlfriend just returned to work last week after having her baby. I went to visit her yesterday to catch up and see how things were going. While she was glad to be back at work, she was stressing about how she was going to be able to continue breastfeeding. As a Certified Lactation Counselor, I happily told her that breastfeeding after returning to work can be a challenge, but it can be done successfully. Here are some tips to make things a little easier:

Before you return to work
• Talk to your employer and let them know what you need to continue breastfeeding. Employers with more than 50 employees are required to give you reasonable time and a private space (that is not a bathroom) for pumping when you go back to work. If there are less than 50 employees, your employer may still be willing to work with you to enable time and space for pumping breast milk.  It is best to familiarize yourself with the federal and state laws as they pertain to your company, and your specific job (exempt or non-exempt). Here are creative solutions to help you and your employer find ways for you to continue breastfeeding. You can search by industry to find the best solution.  Nursing moms who get support from their employer miss less work and are more productive and loyal to their company.
• Whether you have insurance through the ACA (Affordable Care Act) or private insurance, take the time to learn about your coverage. Here is a great tip sheet from the American Academy of Pediatrics that explains the federal guidelines, the differences in health plans and how it affects breastfeeding. This is a must read! Scroll down to the end for a helpful diagram.
• Start back to work on a Wednesday or Thursday. Consider working a few hours a day at the beginning. Having a shorter work week will allow you to get used to your new schedule and figure out your pumping, milk storage and new daycare routine.

• Get a breast pump. If you need help deciding if you should buy or rent one, read our blog. In many cases, breast pumps are covered through your insurance plan, so be sure to inquire. Proper cleaning of the pump is a must; follow the manufacturer’s directions.

• You will need somewhere to keep your breast milk cold. Make sure you have a small cooler with ice packs to bring to work if there’s no refrigerator, or a bag to keep in the fridge. Have labels handy to mark your bottles with the date you expressed the milk.  Learn guidelines for storing and thawing breast milk, here.
Once you have returned to work
• Express milk during the times you would normally feed your baby.
• Keep breast pads handy in case your breasts leak.
• Pump more on the weekends to increase your milk supply.
• Take care of yourself: get as much rest as you can, eat healthy foods and stay hydrated.


Keep talking with your employer about your schedule and what is or is not working for you.  Share the online resource above, and let them know you’d like to continue working together to make a plan that benefits you both.
Going back to work after having a baby can be a difficult transition for many women. Visit our website to learn tips on how to plan for and manage the transition.
Tags: Affordable Care Act, breast milk storage, breast pump, breastfeeding, going back to work, insurance, nursing moms, pumping, pumping at work

Monday, January 26, 2015

Preparing your home for your preemie

We often receive questions about “preemie-proofing” from parents who are preparing for their preemie’s homecoming. You may have waited a long time for this day, but bringing your baby home, and leaving his team of doctors and nurses behind can be overwhelming for many parents. Here are some tips to help ease the transition:

Before your baby comes home:
• Speak with the NICU staff at your baby’s hospital. They are very knowledgeable about what your baby may need when going home.

• If you clean your home before your baby’s arrival, (or if you want to brighten up your preemie’s nursery by painting it) do so before he comes home. This way you can avoid any strong smells that may linger.
• Clean your house of dust and germs. Vacuum and dust often, take out the garbage and keep your kitchen and bathroom clean. Also, tell your baby’s health care provider if you have any pets. Pet hair can track in dirt and dust.

• If your baby needs oxygen, carefully observe the cleaning requirements, particularly for the humidifier, and understand the safety recommendations.
Once your baby is home:

• Your baby should not be exposed to smoke, aerosol sprays or paint fumes. These irritants can cause wheezing, coughing, and difficulty breathing.
• Maintain a smoke-free household. Post signs around your house if you need to so family and friends are aware of your smoke-free home.

• The guidelines for cleaning and storing bottles, nipples, pacifiers, breast pump equipment and milk or formula are the same for preemies as term babies.

• If your baby is on an apnea monitor, be sure you can hear the alarm from every room in your house.

• Wash hands after blowing your nose, diapering your baby or handling raw food. Don’t let adults or children who are sick, have a fever or who may have been exposed to illness, near your baby.
Visit our website here for more great resources for parents after they bring their baby home from the NICU.

What do you remember being helpful when you brought your preemie home? What tips would you recommend to new parents?
Tags: cleaning your home, dust, germs, going home, going home after NICU, NICU, preemie, preterm, smoke-free household

Birth Defects: What have we learned?

Special thanks to Coleen Boyle, PhD, MSHyg, Director, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, for today’s guest post.

Each January, in recognition of National Birth Defects Prevention Month, we at CDC strive to increase awareness about birth defects and reflect upon all that we have learned so far.  We know what causes some birth defects, such as Down syndrome and fetal alcohol spectrum disorders. However, for many birth defects, the causes are unknown.

The good news is that, through research, we’ve learned a lot about what might increase or decrease the risk for birth defects. For example, we know that drinking alcohol during pregnancy can cause a baby to be born with fetal alcohol spectrum disorders. Taking certain medications, having uncontrolled diabetes, and smoking cigarettes are all things that can increase the risk for birth defects. We also know that getting enough folic acid, a B vitamin, starting at least one month before getting pregnant and during early pregnancy lowers the risk of having a baby with a major birth defect of the brain or spine.

Each of these research findings represents a building block, a step toward healthy birth outcomes. Understanding the potential causes of birth defects can lead to recommendations and policies to help prevent them. A great example of this is the research on folic acid, which led to the recommendation that all women who can become pregnant should get 400 micrograms of folic acid every day. This important research also contributed to the evidence needed to add folic acid to foods such as enriched breads, pastas, rice and cereals.

These building blocks start to form our foundation for understanding birth defects and help us identify what we still need to study in the future. While we have a learned a lot, much work remains. We at CDC continue to study the causes of birth defects, look for ways to prevent them, and work to improve the lives of people living with these conditions and their families.

To learn more about birth defects research, we invite you to join us at 1PM EST on January 20, 2015 for CDC’s live webcast titled “Understanding the Causes of Major Birth Defects: Steps to Prevention.” Experts in birth defects research will present an overview of current and historical efforts to understand the causes of major birth defects. They will also discuss the challenges in turning research findings into effective prevention. For more information on the upcoming session, please visit http://www.cdc.gov/cdcgrandrounds/.

This year, we encourage you to become an active participant in National Birth Defects Prevention Month.  Post facts about birth defects marked by the hashtag #1in33 on social media or share your story and how birth defects affect you and your family. Join us in a nationwide effort to raise awareness of birth defects, their causes and their impact.
Tags: birth defects, causes, diabetes, disabilities, Down Syndrome, fetal alcohol spectrum disorders, folic acid, National Birth Defects Prevention Month, prevention, smoking

Monday, January 19, 2015

Make a PACT to prevent birth defects

Each year in the United States, about 120,000 babies (1 in 33) are affected by 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. Birth defects can cause problems in overall health, how the body develops or how the body works. Not all birth defects can be prevented, but there are things that a woman can do before and during pregnancy to increase her chances of having a healthy baby.

January is Birth Defects Prevention Month and this year’s theme is “Making Healthy Choices to Prevent Birth Defects—Make a PACT for Prevention.” If you are thinking of having a baby, follow this PACT:

Plan ahead:
• Get as healthy as you can before becoming pregnant.
• Make sure you are taking 400 micrograms (mcg) of folic acid every day. Studies show that if all women in the United States took the recommended amount of folic acid before and during early pregnancy, up to 70 percent of neural tube defects (NTDs) could be prevented. Folic acid also may help prevent other birth defects, including cleft lip/palate and some heart defects.

Avoid harmful substances:
• Do not drink alcohol, smoke cigarettes, or use street drugs.
• Make sure you are aware of any harmful exposures at work or home and do your best to avoid them.

Choose a healthy lifestyle:
• Eat a healthy diet that includes fruits, vegetables, whole grains, low fat dairy, and lean proteins.
• Exercise and stay physically active.
• Make sure you work with your health care provider to get any pre-existing medical conditions, such as diabetes or high blood pressure, under control and managed.

Talk to your doctor:
• Get a preconception checkup before pregnancy and make sure you go to all of your prenatal visits during pregnancy.
• Discuss all medications you are taking with your doctor. This includes both prescription meds and over-the counter medicines.
• Review your family health history.

So this year, make a PACT to prevent birth defects by following these healthy guidelines. The National Birth Defects Prevention Network’s website has more information.

Monday, January 12, 2015

Your daily folic acid dose

If you are pregnant or thinking about becoming pregnant, folic acid is important to help prevent certain birth defects. But did you know that even if you are not trying to get pregnant, folic acid is still good for your body?

Folic acid is a B vitamin that promotes cell growth. Your skin, hair and nails make new cells every day. Folic acid also plays an important role in helping red blood cells carry oxygen from your lungs to all parts of your body. Some studies even show that folic acid may help protect you from heart disease.

Folic acid can be found in its natural form (called folate) in spinach, black beans, peanuts and orange juice. But it is really hard to get the amount you need from food.

The manufactured or synthetic form of folate is called folic acid. There are many synthetic forms of folic acid: fortified grains, pastas and breakfast cereals. “Fortified” means that folic acid has been added to the food. However, the easiest way to get your recommended folic acid dose, is to take a multivitamin containing at least 400 mcg of folic acid per serving (or 600 mcg if you are pregnant) every day.

As this week is National Folic Acid Awareness Week, it is a good time to check your diet and vitamin pills to be sure that you are getting the recommended amount of folic acid.

If you are like me, and don’t like swallowing pills, you can find a variety of chewable and gummy multivitamins at your local grocery, pharmacy or discount store to suit your tastes and needs. Just be sure to read the labels – some serving sizes, particularly the gummy vitamins, require you to take two tablets to meet your daily recommended dose.

So even if you are not planning on becoming pregnant anytime soon, with so many benefits, you have all the reason you need to start getting your daily recommended folic acid fix.


 

Wednesday, January 7, 2015

The March of Dimes Greets the New Year with Six Simple Resolutions for a Healthy Pregnancy


January is Birth Defects Prevention Month and National Folic Acid Awareness Week

The March of Dimes is encouraging women who are pregnant, or planning to become pregnant, to make a New Year’s resolution to be as healthy as they can, including taking a daily multivitamin containing folic acid every day to prevent serious birth defects of the brain and spine.


”A mom’s health during pregnancy has a direct impact on her baby’s health,” said Dr. Siobhan Dolan, a medical advisor to the March of Dimes and co-author of the non-profit’s book Healthy Mom, Healthy Baby: The Ultimate Pregnancy Guide. “There are many things a woman can do to help give her baby the best opportunity to be born healthy.”
Birth defects affect 1 in every 33 babies born in the United States each year, according to the US Centers for Disease Control and Prevention.

January is Birth Defects Prevention Month, and the week of Jan 5th through 12th is set aside for Folic Acid Awareness Week. Folic acid is a B vitamin proven to prevent serious birth defects of the brain and spine known as neural tube defects (NTDs), such as spina bifida and anencephaly.
About half of pregnancies are unplanned. The March of Dimes urges all women of childbearing age to take a multivitamin containing 400 micrograms of folic acid every day prior to conceiving and 600 to 800 micrograms after becoming pregnant. It’s also good to eat foods that contain folate, the natural form of folic acid, including lentils, green leafy vegetables, black beans, and orange juice. In addition, there also are some foods fortified with folic acid, such as enriched grain products (bread, pasta, and cereals).

Besides taking a daily multivitamin containing folic acid, here are other resolutions for women who may become pregnant:
·    Don’t smoke and avoid second hand smoke. Smoking increases the risk of premature birth and the risk of oral clefts.
·    Don’t use alcohol or illegal drugs. They can cause lifelong health problems for the baby, including fetal alcohol syndrome.
·    Check with your doctor before taking any medication, including herbal products, prescription pain medications, and statins. Some studies have found that women who took some prescriptions pain medications had a higher risk of having a baby with a heart defect, spina bifida, or gastroschisis, a hole in the abdominal wall.
·    Maintain a healthy weight. Being very overweight or underweight can increase the risk of prematurity and birth defects.
·    Be Food Smart. Avoid fish high in mercury or lead, raw and undercooked meat and unpasteurized juice and dairy products and reduce caffeine.

“The New Year will be full of surprises. So even if you’re not pregnant, but want children in the future, resolve to help give them a healthy start in life,” said Dr. Dolan.
About March of Dimes
The March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality. The March of Dimes is the leading nonprofit organization for pregnancy and baby health. For more than 75 years, moms and babies have benefited from March of Dimes research, education, vaccines, and breakthroughs.
For the latest resources and health information, visit our websites marchofdimes.org and nacersano.org. To participate in our annual signature fundraising event, visit marchforbabies.org. If you have been affected by prematurity or birth defects, visit our shareyourstory.org community to find comfort and support. For detailed national, state and local perinatal statistics, visit persistats.org. You can also find us on Facebook or follow us on Twitter.

 

Monday, January 5, 2015

Are you ready to have another baby?

Everyone has a different opinion about how far apart in age their children should be. Some people like to have their babies very close together, while others like a little more time between each child. But there may be more to consider than just personal preference. A recent study found that women who wait less than 18 months between pregnancies are more likely to give birth before 39 weeks.

The study found that mothers who had less time between pregnancies were more likely to give birth before 39 weeks when compared to women whose pregnancies were 18 months apart or more. Women with pregnancy intervals of less than 12 months were more than twice as likely to give birth prematurely (before 37 weeks) when compared to women whose pregnancies were at least 18 months apart.

“Short interpregnancy interval is a known risk factor for preterm birth, however, this new research shows that inadequate birth spacing is associated with shorter overall pregnancy duration” states  Emily DeFranco, Assistant Professor of Maternal-Fetal Medicine at the University of Cincinnati College of Medicine in Ohio and the Center for Prevention of Preterm Birth at Cincinnati Children’s Hospital Medical Center, and co-author of the study. She adds: “This study has potential clinical impact on reducing the overall rate of preterm birth across the world through counselling women on the importance of adequate birth spacing, especially focusing on women known to be at inherently high risk for preterm birth.”

So if you are thinking about having another baby, make sure you schedule a preconception checkup with your health care provider.  The two of you can discuss any health concerns you may have as well as the time between your pregnancies.  Also, if you have had a premature baby in the past, make sure you discuss ways to reduce your risk of having another premature birth.


This entry was posted on Friday, December 12th, 2014 at 11:44 am and is filed under Mommy, Planning for Baby, Prematurity. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

 

Monday, December 29, 2014

The NICU–what you need to know

Having a baby admitted to the NICU can be frightening and confusing. There is a lot of information to learn and understand very quickly. It is easy to feel overwhelmed, stressed, and anxious. But understanding what is going on and knowing what to expect can help lessen anxiety and make you feel more confident about being a parent in the NICU. We have many resources available online that can help you.

As you probably learned very quickly, the NICU is a busy place. The babies need 24-hour care from a number of different medical professional. Here’s a list of NICU staff and what they do. Some or all of these people may be part of the NICU team at your hospital.

There are a number of conditions that babies may develop while they are in the NICU. It is important to know that every baby is different, and your little one may not have any of these complications or may have only one or two. However, here you can read an overview of some common conditions that may be treated in the NICU. If you have more specific questions about a certain medical condition, please email us at AskUs@marchofdimes.org and we will do our best to get you the information you need.

One of the most intimidating factors of the NICU can be seeing all the different machines that are hooked up to your baby. Here is a guide to some of the common equipment you see in the NICU. Once you understand the purpose of the machines, what they are doing, and how they are helping your baby, you may feel a little more comfortable. You can also read our post about understanding your preemie’s cues, to help you better understand her expressions and reactions.

You have probably already realized that there are many tests your baby will have while she is in the NICU. Blood draws, ultrasounds, eye exams, and weight checks…there is a lot to keep track of during her stay. These tests help diagnose any problems and help determine how they should be treated. They also help to monitor your baby’s progress. If you have any questions about what tests are being done, or the results of any testing, make sure you talk to your baby’s doctor or NICU nurse.

Our NICU Family Support Program offers comfort and materials to NICU families during their baby’s stay. The March of Dimes currently partners with over 120 hospitals in the US. You can ask the head nurse of your NICU whether your hospital is a NICU Family Support Partner.

Finally, one of the most important resources that you can access is Share Your Story.  Reaching out to other parents who understand exactly what you are going through can be very helpful. Giving and receiving comfort, support, and advice can help you to stay positive during your baby’s time in the NICU.