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Wednesday, July 30, 2014

Group B strep infection


Between 35-37 weeks of your pregnancy your prenatal care provider will test you for Group B strep. Group B streptococcus (also called Group B strep or GBS) is a common type of bacteria that can cause infection.

Many people carry Group B strep—in fact about 25% of pregnant women are carriers.  GBS bacteria naturally live in the intestines and the urinary and genital tracts. It is not known how GBS is transmitted in adults but you can’t get it from food, water, or things you touch. An adult can’t catch it from another person or from having sex, either.  Most people do not even know they are carriers since adults usually show no signs or symptoms related to GBS.

GBS, however, can be passed to your newborn during labor and delivery and it can make your baby very sick. Babies with a GBS infection may have one or more of these illnesses:

• Meningitis, an infection of the fluid and lining around the brain

• Pneumonia, a lung infection

• Sepsis, a blood infection

According to the CDC, in the US, group B strep is the leading cause of meningitis and sepsis in a newborn’s first week of life.

There are two kinds of GBS infections:

1. Early-onset GBS: Signs like fever, trouble breathing and drowsiness start during the first 7 days of life, usually on the first day. Early-onset GBS can cause pneumonia, sepsis or meningitis. About half of all GBS infections in newborns are early-onset.

2. Late-onset GBS: Signs like coughing or congestion, trouble eating, fever, drowsiness or seizures usually start when your baby is between 7 days and 3 months old. Late-onset GBS can cause sepsis or meningitis.

The good news is that early-onset GBS infection in newborns can be prevented by a simple test. During your third trimester, your provider will take a swab of the vagina and rectum. Results are available in a day or so. This test will need to be done in each pregnancy.

If you do have GBS, then your provider will give you an antibiotic through an IV (medicine given through a tube directly into your bloodstream) during labor and delivery. Usually this is penicillin (if you are allergic to penicillin, there are other options available). Any pregnant woman who had a baby with group B strep disease in the past, or who has had a bladder (urinary tract) infection during this pregnancy caused by group B strep should also receive antibiotics during labor.

Unfortunately late-onset GBS cannot be prevented with IV antibiotics. Late-onset GBS may be due to the mother passing the bacteria to her newborn, but it may also come from another source, which is often unknown.

Treatment for babies infected with either early-onset GBS or late-onset GBS is antibiotics through an IV.

Currently researchers are testing vaccines that will help to prevent GBS infections in both mothers and their babies.

If you have any questions about this topic or other pregnancy and newborn health issues, please email the Pregnancy and Newborn Health Education Center at askus@marchofdimes.org.

Monday, July 28, 2014

Cleft and craniofacial awareness and prevention month

July is cleft and craniofacial awareness and prevention month. Craniofacial abnormalities are  defects of the head (cranio) and face (facial) that are present when a baby is born. Cleft lip and/or cleft palate are a couple of the most common abnormalities.

Craniofacial abnormalities can range from mild to severe. These defects can present a variety of problems including eating and speech difficulties, ear infections and misaligned teeth, physical learning, developmental, or social challenges, or a mix of these issues. However, there are steps you can take to help prevent cleft and craniofacial defects before your baby is born.

What increases the risk of having a baby with craniofacial abnormalities?

We’re not sure what causes these defects. Some possible causes are:

• Changes in your baby’s genes. Genes are part of your baby’s cells that store instructions for the way the body grows and works. They provide the basic plan for how your baby develops. Genes are passed from parents to children.

• Diabetes. Women who have diabetes before they get pregnant have a higher risk of having a baby with a cleft or craniofacial birth defect.

• Maternal thyroid disease. Women who have maternal thyroid disease or are treated for the disease while they are pregnant have been shown to have a higher risk of having a baby with an abnormality.

• Not getting enough folic acid before pregnancy. Folic acid is a vitamin that can help protect your baby from birth defects of the brain and spine called neural tube defects. It also may reduce the risk of oral clefts by about 25 percent.

• Taking certain medicines, like anti-seizure medicine, during pregnancy.

• Smoking during pregnancy.

• Drinking alcohol during pregnancy.

• Having certain infections during pregnancy.

How can you prevent cleft and craniofacial defects?

There are steps you can take to decrease the chance of having a baby with cleft and craniofacial defects.

• Before pregnancy, get a preconception checkup. This is a medical checkup to help make sure you are healthy before you get pregnant.

• Take a multivitamin that contains folic acid. Take one with 400 micrograms of folic acid before pregnancy, but increase to one with 600 micrograms of folic acid during pregnancy. Your provider may want you to take more – be sure to discuss this with him.

• Talk to your provider to make sure any medicine you take is safe during pregnancy. Your provider may want to switch you to a different medicine that is safer during pregnancy.

• Don’t smoke.

• Don’t drink alcohol.

• Get early and regular prenatal care.

If you have any question about cleft or craniofacial defects, causes or prevention, read more here or email us at Askus@marchofdimes.com.

Monday, July 21, 2014

Postpartum depression: more common than you think

Most of us have heard about postpartum depression (PPD). But you may not know that PPD is the most common health problem for new mothers.

For most women, having a baby brings joy and happiness. However, the sudden change in hormones after childbirth leaves many women feeling sad or moody. This is common and is often referred to as the baby blues. But about 1 in 8 new moms have more than a mild case of baby blues. These women experience strong feelings of sadness that last for a long time and can make it difficult for them to take care of their baby. This is called postpartum depression (PPD).

PPD can happen any time after childbirth, although it usually starts during the first three months. It is a medical condition and it requires medical treatment.
We’re not sure what exactly causes PPD but it can happen to any woman after having a baby. We do know that certain risk factors increase your chances to have PPD:
• You’re younger than 20.
• You’ve had PPD, major depression or other mood disorders in the past.
• You have a family history of depression.
• You’ve recently had stressful events in your life.

You may have PPD if you have five or more of the signs below and they last longer than 2 weeks.

Changes in your feelings:
• Feeling depressed most of the day every day
• Feeling shame, guilt or like a failure
• Feeling panicky or scared a lot of the time
• Having severe mood swings

Changes in your everyday life:
• Having little interest in things you normally like to do
• Feeling tired all the time
• Eating a lot more or a lot less than is normal for you
• Gaining or losing weight
• Having trouble sleeping or sleeping too much
• Having trouble concentrating or making decisions

Changes in how you think about yourself or your baby:
• Having trouble bonding with your baby
• Thinking about hurting yourself or your baby
• Thinking about killing yourself

If you’re worried about hurting yourself or your baby, call emergency services at 911 right away.

If you think you may have PPD, call your health care provider. Your provider may suggest certain treatments such as counseling, support groups, and medicines. Medicines to treat PPD include antidepressants and estrogen. If you’re taking medicine for PPD don’t stop without your provider’s OK. It’s important that you take all your medicine for as long as your provider prescribes it.

PPD is not your fault. It is a medical condition that can get better with treatment so it is very important to tell your doctor or another health care provider if you have any signs. The earlier you get treatment, the sooner you can feel better and start to enjoy being a mom.


This entry was posted on Friday, June 20th, 2014 at 8:38 am and is filed under Baby, Mommy. 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.

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Wednesday, July 16, 2014

Thirdhand smoke is dangerous

Thirdhand smoke, the residue left behind in a room where someone has smoked, is harmful to your child.

You have heard how smoking can negatively affect your pregnancy by causing birth defects and nearly doubling your risk for preterm birth. You may also know about the harmful effects of secondhand smoke on your health and that of your children.
What is thirdhand smoke?

Thirdhand smoke is the residual chemicals and nicotine left on surfaces by tobacco smoke. The American Academy of Pediatrics (AAP) states that a few days or weeks after a cigarette is smoked, particles remain on all types of surfaces. Thirdhand smoke can be found anywhere – on the walls, carpets, bedding, seats of a car, your clothing, and even in your child’s skin and hair. Long after someone has stopped smoking, thirdhand smoke is present. Infants and children can inhale, ingest and touch things that result in exposure to these highly toxic particles.
Thirdhand smoke can be just as harmful as secondhand smoke and can lead to significant health risks. The AAP says that children exposed to smoke are at increased risk for multiple serious health effects including asthma, respiratory infections, decreased lung growth, and sudden infant death syndrome (SIDS).

The residue left from smoking builds up over time. Airing out rooms or opening windows will not get rid of the residue. In addition, confining smoking to only one area of the home or outside will not prevent your child from being exposed to thirdhand smoke.

There are ways you can limit or prevent thirdhand smoke. AAP recommends:

• Hire only non-smoking babysitters and caregivers.

• If smokers visit your home, store their belongings out of your child’s reach.

• Never smoke in your child’s presence or in areas where they spend time, including your home and car.

• If you smoke, try to quit. Speak with your child’s pediatrician or your own health care provider to learn about resources and support.

The only way to fully protect against thirdhand smoke is to create a smoke-free environment. For more information on how to quit smoking, visit http://smokefree.gov/.

 

Monday, July 14, 2014

It’s good – no, great – to read to your baby

Read to your baby- it’s fun for both of you. And now the AAP says it is important for your baby’s language and brain development, too. Sounds like a win-win to me.

Someone once asked me how old my children were when I started reading to them. Honestly, it was not like I flipped a switch and then pulled out a book. I read to them as soon as they could open their eyes. I remember my son being on my lap and barely able to hold his head up as I read him a soft “baby book” with huge, colorful shapes and pictures. He sat there enthralled, gazing at the colors with wide eyes. Sometimes he would lunge forward to touch the colors. He was barely three months old.

When I gave birth to my daughter two years later, I would sit on my large blue chair with my son on one leg and my daughter nestled on my arm on my other leg. My son would turn the pages and I would read to both of them. I treasured our special time together, and my kids absolutely loved it. Even though my kids are in their twenties now, I still have the “reading chair” and just sitting in it evokes the sweetest of memories for me. But, perhaps the best part of this bonding ritual was that both my children grew to love reading at a very early age.

The American Academy of Pediatrics (AAP) is actively urging pediatricians to tell parents to read to their child from infancy. Reading aloud helps to promote language skills – vocabulary, speech, and later reading comprehension, literacy and overall intelligence. The AAP suggests that pediatricians extol the virtues of reading to children at each “well child” visit. Reading to your child is right up there with proper nutrition and vaccinations. Yup – according to science, reading aloud to kids is good for them.

Where to get books

You don’t need to own a large library to read to your child. Kids love repetition and will ask to hear the same story over and over again. (How many times did I read Go Dog Go by P.D. Eastman?!!!). But if you just can’t pick up that same book again, head to your local library where the children’s section is sure to bring out your inner child. As your baby gets older, make reading interactive – have him point to the truck when you say the word. Then have him repeat the word or say it with you. Watch as his vocabulary begins to grow. You can practically “see” the connections being made.

Another place to acquire books for a home library is at second hand stores or even recycling stations. The “dump” in the town where I raised my kids has a book shed where you can drop off or pick up used books for free. And don’t forget, garage or yard sales are great places to get books for nickels. Having a mini-library at home has been shown to help children get off on the right academic foot.

When your little one is a toddler, check out library story hours for parents or caregivers and children. It may soon become the highlight of your week.

Bottom line

It is never too early to start reading to your baby or too late to start reading to your child. Not only will reading aloud help to boost language skills from an early age, but it will promote bonding and closeness between you and your child. Who knows what world a book may open up to you and your baby?

So, grab a book, snuggle up and start reading. You’ll never regret it.

Wednesday, July 9, 2014

Keeping your child healthy and safe in a pool

Small inflatable or plastic kiddie pools are great fun for small children in the summertime. But, these pools can also make your child sick. The dirty pool water may cause recreational water illnesses (RWIs). RWIs are caused by water that is contaminated by feces or urine. RWIs can be spread by swallowing or having contact with contaminated water.  As the number of children using a pool increases, the more the risk for illness increases.

The CDC offers tips on how to keep your child healthy and safe when using a small inflatable or plastic pool:

• Before your child or any of his friends use the pool, give him a soap bath. Do not allow a child who is ill with diarrhea or vomiting to use the pool.

• During swim time, remind children to avoid getting pool water in their mouths. Take your little one on a bathroom break every hour or check his diaper every 30-60 minutes to help keep germs out of the water. If you see feces in the pool or a child has a dirty diaper while in the pool, clear the pool of children right away. Then, drain the water, clean it, and leave the pool in the sun for at least four hours to kill germs.

• Swim diapers and pants can delay diarrhea-causing germs from leaking into the water, but swim diapers do not keep germs from contaminating the water. If your child wears a swim diaper, remember to continue to take him for frequent diaper changes or bathroom breaks.

• Empty the pool water daily, unless you have a filter system.

• Always watch children carefully. Even small pools with shallow water pose a drowning hazard to children.

• Learn CPR (cardio-pulmonary recessitation). It is a great skill to know in the event a child is drowning. The American Red Cross is one organization that offers widely recognized CPR programs. You can usually find programs in your community.

Learn more about ways to keep your child safe in the water this summer. With a little caution and a few rules, your child can stay cool in a pool.

Monday, July 7, 2014

Breastfeeding myths debunked – part 2

1. Your baby needs water too.

False: Supplementing with water is not recommended for babies. Breast milk or formula contains all the water a baby needs and will keep your baby hydrated even in hot, dry climates.

2. You don’t produce enough milk.

Often False: The amount of milk you produce depends on a number of factors, including how often you feed and how your baby sucks at the breast. You can check if your baby is getting enough to eat by the amount of wet or soiled diapers in a day. The American Academy of Pediatrics tells moms to “expect 3-5 urines and 3-4 stools per day by 3-5 days of age; 4-6 urines and 3-6 stools per 5-7 days of age.” Your baby’s health care provider will check if your baby is gaining weight at his well-baby visits.

3. Breastfeeding is easy

False: Breastfeeding can be very challenging. Many moms face sore, cracked and bleeding nipples. It can hurt when you try to feed your baby. It’s important that when you start to feel pain or discomfort you seek help from a lactation counselor or support group. Many times the soreness can be relieved if the latch or position is changed. Some moms are able to breastfeed right away and others experience discomfort for months. Breastfeeding is learning a new skill; it takes lots of practice, time and patience.

4. Breastfeeding reduces the risk of SIDS

True: Breastfeeding can reduce the risks associated with sudden infant death syndrome (SIDS). Feed your baby only breast milk for at least 6 months. Continue breastfeeding your baby until at least her first birthday. The American Academy of Pediatrics (AAP) says “Breastfeed as much and as long as you can. Studies show that breastfeeding your baby can help reduce the risk of SIDS.”

5. My baby should always breastfeed from both breasts

Not always true: Babies, especially newborns may have periods of preferring only one breast. Your baby may cry, become fussy or refuse to feed on one breast. If your baby is getting enough milk and you are not having any other trouble, it is fine for your baby to feed from only one breast. If you are having problems with your milk supply, or experience engorgement or pain, there are tips to get your baby back on both breasts.  For example try starting your baby on the preferred breast, and then slide him over to other side without changing the position of his body. To learn more, ask a lactation specialist.

Did you have an assumption about breastfeeding that was false? Or did someone give you advice that helped? We’d love to hear from you.

Check out the first 5 breastfeeding myths from last week.

Wednesday, July 2, 2014

Fireworks are not fun for kids with sensitive hearing

For kids with sensitive hearing, fireworks can be frightful instead of fabulous. Here are some tips to get your child to still enjoy this colorful display without suffering pain.

July 4th…the very date evokes images of summer: flags waving, backyard barbeques, ice cream, home town parades and amazing fireworks displays celebrating our nation’s independence. It should be a fun, patriotic display of colors and designs in the night sky, but for kids whose hearing is extra sensitive to sound, it ends up being a torturous event. The loud popping of the firework explosions at unexpected moments creates anxiety and panic. Add to that the additional noisemakers on July 4th such as firecrackers, and this day of celebration for most people becomes a painful day for a child with sensitivities (and a challenging day for his family).

What can you do?

Aside from avoiding firework displays altogether, here are some ways to enjoy them:

•    First, see if you can watch a fireworks display on TV or DVD before going to a live display. Letting your child understand what a fireworks display is all about will help decrease anxiety. Sometimes towns offer fireworks displays on the weekend after the 4th so you can view a TV display beforehand.

•    Park a distance away from the crowds and firework display, and stay in your car. The noise may be muffled enough to allow your child to enjoy the visual display without being close to the noise. Your child will also feel more protected.

•    Have your child use ear plugs or noise cancelling headphones. With the ear plugs, he can still hear some noises and conversations, but the offensive sounds will be significantly decreased.

•    Alternatively, have your child listen to his favorite music (either with ear buds or on the car radio) as the fireworks are going on. It will help camouflage the offending sounds.

Remember, your child cannot help being hyper-sensitive to sound. It is not something he can control. It is painful and upsetting for him to be around sounds that hurt his ears. So, learning how to enjoy events on his terms is key to being able to attend or participate.

For a longer term solution, speak with your child’s pediatrician about possible treatments. Also, email AskUs@marchofdimes.com and request additional resources. We can refer you to a list of books written for children (to help them understand why they feel sensitive) as well as books written for adults (to help you understand your child’s sensory issues). We’re happy to help you!

We hope everyone has a safe and happy 4th of July holiday!

Note:  This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started in January 2013 and appears every Wednesday. While on News Moms Need and click on “Help for your child” in the Categories menu on the right side to view all of the blog posts to date (just keep scrolling down). We welcome your comments and input.

Monday, June 30, 2014

Scleroderma and pregnancy

June is National Scleroderma Awareness Month. Scleroderma is a group of diseases that result in the abnormal growth of connective tissue. Connective tissue is tissue that supports your skin and internal organs, like your kidneys, lungs and heart. Scleroderma is a chronic condition meaning that it lasts for a long time and can affect many aspects of your life.
If you have scleroderma, your body makes too much of a connective tissue protein called collagen. When too much collagen builds up in your body, it causes your skin and connective tissues to get hard or thick. Scleroderma can lead to pain and swelling in your muscles and joints. There are two main kinds of scleroderma: localized and systemic. Both can be mild to severe, with periods of remission (wellness) and flares (illness).
Localized scleroderma only affects certain parts of your body, like your skin, skin tissues and sometimes muscles. Localized scleroderma doesn’t harm major organs and often gets better or goes away over time without treatment. But sometimes it can be severe and cause lasting skin changes.
Systemic scleroderma can affect the whole body, including your skin, tissues, blood vessels and major organs, like your heart, lungs and kidneys.
If you have scleroderma and you’re thinking about getting pregnant,  you should schedule a preconception checkup with your health care provider. If you have localized scleroderma, it may not affect your pregnancy at all. But systemic scleroderma can cause problems with your heart, lungs or kidneys. These complications are most likely to appear during the first three years of scleroderma symptoms, and can cause health difficulties for you and your baby during pregnancy. For this reason, it’s best not to get pregnant during the first three years of symptoms.
If you have systemic scleroderma, you may be more likely than other pregnant women to have:
• Preeclampsia and other kinds of high blood pressure,
• Poor growth in your baby,
• Cesarean birth (C-section).
Right now, there is no specific treatment that stops the body from making too much collagen. However, doctors use several types of medication to control the symptoms. But not all of these are safe to use during pregnancy. Some can cause birth defects if a woman takes them while she is pregnant. That is why it is so important to discuss your condition with your doctor before pregnancy.
During pregnancy a woman with scleroderma may be treated by multiple doctors, including a rheumatologist as well as a high-risk obstetrician. Depending on her individual symptoms, a pregnant woman may need to see a few other providers to treat specific complications. Fortunately though, with today’s medical care, many women with scleroderma can have successful pregnancies.

Wednesday, June 25, 2014

Help for sensory issues

child in ball pitSensory issues can make or break your child’s day, and yours. Last week I discussed the different kinds of sensory problems that many kids experience. Today I offer some treatment options based on parent feedback.

For all of the senses, and especially for tactile sensitivities (touch), Sensory Integration (SI) therapy, a specific kind of therapy used by occupational therapists, has been a popular form of treatment. A recent study showed that a group of autistic children who received SI therapy reduced sensory difficulties in contrast to the children who did not receive SI therapy. It is thought that this form of therapy helps your child’s brain adapt to sensory information so that he can make adjustments in his daily life.
The therapy is lots of fun – it usually involves balls, swings and other game-like movements that engage the senses. It also can include wearing compression clothing to help decrease sensory seeking behavior. Although it has been around for several decades, SI therapy has not been studied until more recently. The American Occupational Therapy Association has information about sensory issues and SI therapy on their website and on this factsheet. The American Academy of Pediatrics (AAP) reminds parents there is limited data on the use of sensory based therapies and recommends that parents and pediatricians work together to determine if SI therapy would be appropriate for your child.
Treatment for eating issues
Since good nutrition is important for health and growth, you may find yourself at your wits end to get your child  to eat a balanced diet. For children with aversions to many foods, occupational therapy may help, too. There are various methods that a therapist may use to gradually get your child used to different textures or tastes.
You might also ask your pediatrician if multivitamins or other supplements are recommended, especially if your child’s taste issues has made it so that he does not eat many foods. I used to open vitamin capsules and mix them in my daughter’s food (such as spaghetti sauce) in order to ensure she got her daily dose of essential vitamins and minerals. Smoothies with vitamins or protein powder may also be a good substitute or addition to a meal.
Another option is to speak with a Registered Dietitian (RD) who specializes in children’s eating issues; they are trained to know how to create balanced diets and often have experience with children who have sensory issues. Ask your child’s doc or call your local hospital for a referral.
Other treatments
Some parents report that acupuncture as well as other kinds of treatment have helped their child decrease sensitivity.  Again, consulting with your child’s pediatrician is important before deciding on a treatment plan.
Where to get more info
  • The March of Dimes’ online community Share Your Story offers a way for parents to share their experiences and treatments for children experiencing sensory problems. Feel free to log on and join a discussion or ask a question.  Parents sharing ideas and information is key to helping your child overcome obstacles.
  • Email AskUs@marchofdimes.com and request additional resources. We can refer you to a list of books written for children (to help them understand why they feel sensitive) as well as books written for adults (to help you understand your child’s sensory issues). We’re happy to help you!
Note:  This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started in January 2013 and appears every Wednesday. While on News Moms Need and click on “Help for your child” in the Categories menu on the right side to view all of the blog posts to date (just keep scrolling down). We welcome your comments and input.
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