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,

• Premature birth,

• 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.

Tags: preconception checkup, prenatal care, scleroderma

Help for sensory issues

Sensory 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.
Tags: child, delays, disabilities, early intervention, occupational therapy, OT, Registered Dietitian, RT, Sensory Integration Therapy, sensory issues, Share Your Story, SI therapy, Special needs

Eat fish during pregnancy

 

When you’re pregnant, it’s important to make healthy food choices. This is especially true when it comes to fish. Fish are a good source of protein, omega-3 fatty acids and other nutrients that can be good for your baby’s health.

The Food and Drug administration (FDA) is changing their guidelines for eating fish during pregnancy. If you’re pregnant or breastfeeding, the FDA now suggests you eat at least 8 and up to 12 ounces a week of fish that are low in mercury. This includes fish like shrimp, salmon, pollock, catfish, canned light tuna, tilapia and cod. It’s OK to eat up to 6 ounces a week of albacore (white) tuna.

However, FDA still says to avoid eating raw fish, like sushi, as well as fish that can be high in mercury, like shark, swordfish, king mackerel and tilefish. And always check with your local health department before you eat any fish you catch yourself.
The new recommendations on eating fish during pregnancy are open for public comment. Share your thoughts! Learn more about eating healthy and foods to avoid or limit during pregnancy.

What you need to know about CMV

June is National Congenital CMV Awareness Month. It is important that all women who are pregnant or thinking about becoming pregnant know about CMV.

What is CMV?

Cytomegalovirus (CMV) is a common viral infection that most of us get at some point in our lives, frequently during childhood. It is usually harmless and does not cause any symptoms. But if a woman becomes infected with CMV for the first time, while she is pregnant, she can pass the virus to her baby. This can lead to serious illness, lasting disabilities or even death.

Why is CMV a concern during pregnancy?

CMV is the most common congenital (present at birth) infection in the United States. Fortunately, most babies born with CMV never have symptoms or problems caused by the infection.

However, some babies born with CMV develop one or more conditions during the first few years of life, such as hearing loss, vision loss, learning disabilities, and intellectual disabilities.

A woman who contracts CMV for the first time during pregnancy has about a 1-in-3 chance of passing the virus on to her fetus. She can pass CMV on to her baby at any stage of pregnancy. However, studies suggest that babies are more likely to develop serious complications when their mother is infected in the first 20 weeks of pregnancy.

How do you get CMV?

You can get CMV by coming into contact with bodily fluid from a person who carries the virus. You may be more likely than other people to get CMV if you have young children at home, work with young children, or work in health care. Most people with CMV have no signs or symptoms, so if you’re a health care or child care worker talk to your doctor about getting tested for CMV before pregnancy to see if you’ve already been exposed to the virus.

How can you prevent CMV?

You can help prevent CMV infection by doing the following:

• Wash your hands well, especially after being in contact with children and body fluids. Wash your hands after changing diapers, wiping noses and picking up toys.

• Carefully throw away used diapers and tissues.

• Don’t kiss young children on the mouth or cheek.

• Don’t share food, glasses, cups, forks or other utensils with young children or with anyone who may have CMV.

Is the March of Dimes conducting research on CMV?

Yes! March of Dimes grantees and other researchers are developing and testing vaccines that may help protect babies against CMV. Recent March of Dimes grantees have been studying how this virus multiplies and spreads in the unborn baby, in order to develop effective drugs that can help prevent disabilities in infected babies.

Tags: CMV, congenital CMV, cytomegalovirus

 

Sensory difficulties in children

Itchy shirt. Icky foods. Hair brushing is a nightmare. Shoes won’t stay on. Sounds make him cringe.

Picky child or sensory dysfunction?
Our five senses: taste, smell, hearing, touch and sight help us navigate so much of our world. But for some children (and even adults), their senses are especially heightened and can interfere with daily life in a negative way.

•    Taste and smell
Parents often complain that their child can’t tolerate the taste or smell of many foods. Feeding their child becomes a nightmare. When my daughter was little, she would only eat approximately 10 foods (if that). She did not like the taste or smell of most foods and could not stay in the same room when I was cooking broccoli or another offending food.  She preferred sweets to salty treats, and a vegetable would not pass her lips (she would rather die fighting!).  Even if cajoled or bribed (yes – I bribed her) to eat a new food, she would often gag on it because the taste, smell or texture was too awful for her. As she grew up she would relate that she wanted to eat more foods, and was not happy that she had such a limited range of foods she found acceptable to eat. But, alas, it was not something she could control.

•    Sound
Another common sensory complaint is that of a hearing sensitivity. Certain sounds or noises are painful to hear. I am not talking about a rock concert or music being cranked on the highest volume. The bothersome sounds could be the barking of a dog, the crinkling of tin foil, the din of the voices in a cafeteria, the sound of a blender, hair dryer or vacuum cleaner. Typical sounds are abnormally loud to a child with a sound sensitivity and may cause him to cover his ears (at best) or disengage socially (at worst).

•    Touch
Other children are extra sensitive to touch. For example, they hate the feeling of certain clothes against their skin. They dislike getting dressed or undressed, and may have a vast wardrobe but will only wear three outfits! Clothes that are scratchy, have tags or are not soft enough for their skin will be tossed aside.  They may resist going into a bath (or getting out of the bath) due to the uncomfortable sensory changes on their skin. Similarly, applying sunscreen becomes a feat in and of itself.

•    Sight
Lastly, some children are extra sensitive visually. For example, bright lights, flashing lights and the change from indoor light to sunlight can make them close their eyes or head in the opposite direction.

Any one of the above sensory issues can wreak havoc on your child’s life – and yours. Some children have difficulties with more than one sense, too. There is debate as to whether sensory dysfunction is a diagnosis in and of itself, or if it is a symptom of a larger diagnosis (such as ADHD, autism, or another disorder). The important thing to remember is that for whatever reason, and whatever you want to call it, these sensory issues are real challenges in your child’s life.

In many cases, these sensitivities may be reduced through occupational therapy (read this post on OT) and through other kinds of treatments. If your child is extra sensitive, speak with his pediatrician and ask if OT or another kind of treatment may be helpful.

Stay tuned for future blog posts on treatment options and helpful hints for the above sensory issues.

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. If you have questions, please send them to AskUs@marchofdimes.com.

Tags: child, children, delays, disabilities, feeding problems, light, occupational therapy, OT, premature birth, senses, sensitivities, sensory defensiveness, sensory dysfunction, sensory issues, sensory processing disorder, sound sensitivity, sounds, Special needs

Breastfeeding myths debunked

Whether you are currently breastfeeding or planning to breastfeed in the future, there are many myths that could lead you toward or away from breastfeeding.

1. Breastfeeding will ruin my breasts.

False: breastfeeding does not affect the shape of your breasts. Your breasts may become engorged while breastfeeding, but your breasts will return to their usual shape once you have weaned feedings. Aging and gravity are the culprits of changing breast shape!

2. Breastfeeding will make my nipples sore.

True and False: Breastfeeding may make your nipples sore, but there are things you can do to prevent or solve the soreness. Sore nipples may happen when the baby is not latched on properly. You can seek help and support from a lactation counselor or support group.

3. Breastfeeding may help you lose your baby weight.

True! Breastfeeding burns extra calories (up to 500 a day), helping you return to your pre-pregnancy weight in a gradual and healthy way.  Remember pregnancy weight was not gained overnight so it will not disappear quickly. It is important to maintain a healthy diet and to wait until you feel ready and for your health care provider’s OK to purposely lose weight.

4. You must drink milk to make milk.

False: You do not need to drink milk to make milk. However it is important for you to maintain a healthy diet of vegetables, fruits, grains, proteins and water. These are the only nutrients you need to produce milk. If you are concerned about getting enough calcium, you can drink milk or eat non-dairy foods that contain calcium such as dark green vegetables or nuts.

5. My milk isn’t good enough.

False: Breast is still best. Breast milk composition changes within the feeding, within the day and over the course of lactation, but breast milk has higher amounts of nutrients than other foods or supplements, including formula. Your breast milk can help protect your baby from things like diarrhea and infections, and help brain development.

These are the first 5 myths debunked. Stay tuned next week for more.

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.

Tags: breastfeeding, engorged, feeding, lactation, losing weight, sore nipples, support

Sunscreen safety for pregnant women

Summer is here! Sunscreen is important whenever you are outside, especially if you are pregnant. During pregnancy your skin is more sensitive to sunlight than it was before pregnancy. The sun gives off ultraviolet radiation (UV) which can increase the risk of skin cancer, give you a bad burn and increase signs of aging.

There are two types of rays that can cause skin damage. These are ultraviolet A and ultraviolet B radiation (UVA and UVB). Both of these can cause premature aging and skin cancer however UVB rays are what cause sunburn. It is important to choose a sunscreen that protects against both UVA and UVB. But, choosing the right sunscreen to slather on can be confusing.

Here are tips on choosing the right sunscreen for you:

•    Avoid retinyl palmitate This type of vitamin A has been linked to an increased risk of skin cancer and is associated with a risk of birth defects.
•    Choose sunscreen with a sun protected factor (SPF) of 15 or higher.
•    Only use products that have UVA and UVB protection – also called Broad Spectrum protection
•    Use a water resistant sunscreen if you intend to go swimming
•    Reapply sunscreen every two hours, or more often if you are swimming or sweating (even if you use water resistant sunscreen).
•    Limit your time in the sun between 10 a.m. and 2 p.m. when the sun rays are most intense.

Combination products

To fend off those pesky mosquitoes, there are also combination sunscreen products that include bug spray. These can be  great two-for-one products, but combination sunscreens may be more hazardous that you thought. A combination product has the possibility of toxic exposure, due to overdosing on the bug repellant. It’s safe to apply the combination lotion first, but when it’s time to reapply, skip the combination and just use sunscreen.

Read our post for specific tips on how to keep your baby safe in the sun.

Have fun outside this summer, but wear your hat, sunglasses, stay well hydrated and remember your sunscreen!

Tags: Baby, broad spectrum, bug spray, combination products, pregnant woman, retinyl palmitate, skin, SPF, sunblock, sunburn, sunscreen, UVA, UVB, water resistant

 

Preemies- adjusted age and delays

All babies develop at their own rate. But there is a special way to determine if premature babies are developing as they should.

Babies who are born prematurely have two ages: chronological and adjusted.  Chronological age is the age of your baby from the day of his birth—the number of days, weeks or years old that your baby has been in the outside world.  Adjusted age is the developmental age of your baby based on his due date (when he would have been born).

To calculate adjusted age, take your premature baby’s chronological age and subtract the number of weeks your baby was premature.  For example, a baby who has a chronological age of 10 weeks but was born 4 weeks early has an adjusted age of 6 weeks. (10 – 4 = 6)

Why is this important?

Since so much of a baby’s growth and development takes place during pregnancy, babies who are born prematurely miss out on valuable developmental time. As a result, they may lag behind other babies who share their actual birthday. Health care providers may use your baby’s adjusted age when they evaluate your baby’s growth and development.

An infant who is 12 months old but was born 2 months early (and consequently has an adjusted age of 10 months) should not be compared to other 12 month old babies. Instead, he should be compared to other 10 month old babies. Then, his growth and development will seem more in line with typical developmental milestones.

Measuring delays

As your child grows, it may become awkward to constantly have two ages. Hopefully, as time passes, he will begin catching up to his chronologically same-aged peers. Some preemies catch up completely; others have delays or developmental issues that last for years. No two children are exactly alike. But, if you understand that your preemie should be evaluated based on his adjusted age (especially in the early months/years of his life), then it becomes easier to determine if he is delayed and if he is making timely progress.

You can learn more about developmental milestones in preemies by watching our video.

Get help early

If your child is not meeting his developmental milestones or is at risk of having a delay, specialists may be needed to help optimize your baby’s progress. Just as a person may need physical therapy to improve movement after an injury, a toddler who was born prematurely may need physical therapy to help him learn to move or walk. Many preemies have vision or hearing problems which may cause speech difficulties; the help of a speech therapist can make all the difference in helping him learn to talk.

Fortunately, in the United States, the Early Intervention program is there to help babies and toddlers who are experiencing developmental delays. Read this blog series to learn how to access this system and help your child get off on the right foot. If you suspect that your child is struggling or is delayed, it is best to get help as soon as possible – don’t delay with delays.

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. If you have questions, please send them to AskUs@marchofdimes.com.

 

Tags: adjusted age, chronological age, delays, developmental milestones, disabilities, early intervention, preemies, prematurity, specialists

Signs and symptoms of preeclampsia

Preeclampsia is a condition that happens only during pregnancy (after the 20th week) or right after pregnancy. It’s when a pregnant woman has both high blood pressure and protein in her urine.

It really is very important that all pregnant women are familiar with the signs and symptoms of preeclampsia. Without treatment, preeclampsia can cause kidney, liver and brain damage in the mother. It also may affect how the blood clots and cause serious bleeding problems.

And even today, in rare cases, preeclampsia can become a life-threatening condition called eclampsia. Eclampsia is when a pregnant woman has seizures following preeclampsia. Eclampsia sometimes can lead to coma and even death.

Signs and symptoms of preeclampsia may include:
• Severe headaches
• Vision problems, like blurriness, flashing lights, or being sensitive to light
• Pain in the upper right belly area
• Nausea or vomiting
• Dizziness
• Sudden weight gain (2 to 5 pounds in a week)
• Swelling in the legs, hands, and face

Some women may not have any signs or they may confuse them with the normal discomforts of pregnancy. That is why it is so important to see your health care provider regularly and keep all of your prenatal care appointments. Your provider measures your blood pressure and checks your urine for protein at every visit. Because you can have mild preeclampsia without symptoms, it’s important to go to all of your prenatal care visits. And if you have severe headaches, blurred vision or severe upper belly pain, call your health care provider right away.

We don’t know what causes preeclampsia. But you may be more likely than other women to have preeclampsia if:
• It’s your first pregnancy.
• You had preeclampsia in a previous pregnancy.
• You have a family history of preeclampsia. This means that other people in your family have had preeclampsia.
• You have high blood pressure, kidney disease, diabetes, certain blood-clotting disorders, lupus or other autoimmune disorders.
• You’re pregnant with multiples (twins, triplets or more).
• You’re older than 35.
• You’re African-American.
• You’re overweight or obese (If you’re obese, your BMI is 30.0 or higher before pregnancy)

If you’re overweight or obese, getting to a healthy weight before pregnancy may help lower your chances of having preeclampsia.

The only cure for preeclampsia is the birth of your baby. But it can be treated. Treatment depends on how severe your preeclampsia is and how far along you are in your pregnancy. Even if you have mild preeclampsia, you need treatment to make sure it doesn’t get worse.

There is no way to prevent preeclampsia. But being aware of the signs and symptoms and making sure that you see your prenatal care provider regularly can help to detect it early. Next week, we’ll review what can happen to your baby if you have preeclampsia.