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.

Tags: accidental poisoning, e-cigarettes, electronic cigarettes, liquid nicotine, nicotine, nicotine poisoning

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:

• Premature rupture of membranes
• Changes in the baby’s heart rate
• Placental abruption
• Preterm labor

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

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

Tags: eating, exercise, healthy pregnancy, holiday stress, holidays, Pregnancy, prematurity, sleep, stress, stressed

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.

• Spending holidays in the NICU will give you ideas on how to brighten your Hanukkah, Christmas or New Year’s eve if your baby is still in the hospital.
• Toys glorious toys! will give you shopping ideas for children with special needs. Be sure to keep your child’s adjusted age in mind if she was born prematurely.
• Going to do a bit of traveling over the holidays? Prepare your child with special needs for the trip, to avoid hiccups that could turn into meltdowns.
• Is the thought of bringing your young child to a relative’s house for dinner giving you a sense of dread instead of excitement?  These two posts may help: Bracing for the holidays and Holidays or :(.  Learn tried and true tips from parents of kids with special needs.
• Visiting Santa is do-able for kids with special needs is a post that explains the options that exist for children with sensory challenges. Read on to locate a sensory special Santa in your area to take the angst out and put the joy into this visit.

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.

 

Tags: adjusted age, holidays, NICU, premature, Santa, sensory challenges, Special needs, toys, transitions, traveling, trips

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

Tags: babies, birth defects, hearing impairment, hearing loss, newborn screening, prematurity

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.

Tags: bedtime, Pregnancy, reduce your stress, relaxation, sleep, sleeping

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.

Tags: breast milk, breastfeeding, donor milk, milk bank, NICU, preemie, prematur birth, premature baby, prematurity

Knowing your family health history may help your baby

Recently I had an appointment with a new healthcare provider and had to complete a health history form at my first visit. It was 3 pages long and took me about 20 minutes to do while in the waiting room. As I was sitting there, I realized that I didn’t know the answers to some of the questions, especially about my relatives.

Was this really that important?

In one word? Yes.

A family health history (FHH) form is a record of health conditions and treatments that you, your sisters, brothers, parents, aunts, uncles, grandparents and great grandparents have had. It can help you figure out the medical problems that run in your family. Knowing your FHH may just save your life. It may also have a direct effect on your baby’s health.

How can a FHH form help your baby?

The FHH form will help your provider see if any of the conditions or diseases that run in your family will affect your baby. For example, premature birth can run in families. And, certain conditions such as diabetes or high blood pressure put you at a higher risk to have a premature baby.

If you and your partner complete a FHH form and share it with your prenatal provider, you may learn about the health of your baby before she is born. The earlier in your pregnancy that your provider is aware of health conditions, the sooner your provider can decide on treatments for you.

It would be even better if you could complete and share this information with your provider before pregnancy, at a preconception checkup. This way, your provider can help you become as healthy as possible before pregnancy.

Use our FHH form

Here is a form that you can print out and complete.  Print one copy for yourself and one for your partner/spouse. We suggest you take it with you to family gatherings (Thanksgiving anyone?) and ask your relatives to help you fill in the blanks. You may very well find out information about diseases and conditions that run in your family and put you at risk. Early detection is often key in successfully managing a disease.

Here are tips on how to gather information from relatives.

Knowing your risk for certain conditions and that your provider is on top of treatment options, should put your mind at rest. And, knowing you are doing your best to take care of your baby’s health should make you feel even better.

So, when you sit down to apple pie, start a conversation, and fill in your FHH form. The information you share with your family may make a positive difference in everyone’s lives.

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

Tags: family health history, preconception checkup, preexisting conditions, premature birth, prematurity, risk factors

Genetic Tests of Amniotic Fluid Could Help Guide Treatment of Preterm Births

Researchers funded in part by the March of Dimes report that they have identified a way to conduct genetic tests of amniotic fluid in pregnant women to better determine the medical needs of premature babies, it was reported today in the journal BMC Medical Genomics.

Critical development of vital organs such as the brain, heart, and lungs occurs during the final weeks of pregnancy, which should last at least 39 weeks, the March of Dimes says. Today’s finding is important because no test currently exists that can reliably measure the maturity of these organs before birth, the authors note.

Preterm birth is the leading killer of babies in the United States, and those who survive an early birth often face serious and sometimes lifelong health challenges, such as breathing problems, jaundice, developmental delays, vision loss, and cerebral palsy. Even babies born just a few weeks too soon have higher rates of death and disability than full-term babies. However, some medical conditions make it necessary for babies to be delivered before the full 39 weeks of pregnancy.

"This study demonstrates the feasibility of testing amniotic fluid to identify biomarkers for fetal organ maturation to better enable obstetricians to make delivery planning decisions for preterm births," said Beena Kamath-Rayne, MD, MPH, a lead author and researcher in the Perinatal Institute at Cincinnati Children's Hospital. "This will allow pediatricians and neonatologists to prepare for the various neonatal morbidities these preterm infants may face, and allow obstetricians to better weigh risks to the baby when making decisions about preterm delivery."

Researchers identified 257 genes that were expressed differently in late preterm fetuses (34-36 weeks) compared to those at full-term. Through additional analysis, the authors linked genes expressed differently in preterm babies to underdeveloped lungs, decreased lean body mass, and immature feeding patterns. The authors emphasize that additional research is needed beyond the current study, in part because of the small study sample.

Co-author Louis J. Muglia, MD, PhD, is the principal investigator of the March of Dimes Prematurity Research Center – Ohio Collaborative, composed of scientists from diverse disciplines: genetics, molecular biology, epidemiology, engineering, computer science and others. They are working together to find the unknown causes of premature birth and how to prevent it.

“The innovative, team-based model of the March of Dimes Prematurity Research Centers is critical to understanding the unknown causes of preterm birth. This new finding adds one small piece toward solving the much larger puzzle of preventing and treating preterm birth,” says Dr. Muglia.

In addition to the Ohio Collaborative, the March of Dimes has established four other Prematurity Research Centers nationwide: at Stanford University School of Medicine in California; University of Pennsylvania; Washington University in St. Louis; and University of Chicago-Northwestern University-Duke University.

“Systems biology evaluation of cell-free amniotic fluid transcriptome of term and preterm infants to detect fetal maturity” by Dr. Kamath-Rayne et al. was published online today by BMC Medical Genomics.

380,000 babies born too soon in the U.S.

This year, the United States received a “C” on the March of Dimes 2015 Premature Birth Report Card. Although the overall rate of preterm birth dropped to 9.6% in 2014, 1 in 10 babies in the U.S. is born too soon. And despite the decline, the U.S. preterm birth rate continues to rank among the worst of high-income countries.

Four states received an “A” on the report card—Oregon, Washington, Idaho, and Vermont. All of these states had a preterm birth rate of 8.1% or less. Louisiana, Alabama, Mississippi, and Puerto Rico all received an “F.” Their preterm birth rates were 11.5% or greater.

For the first time this year, in addition to grading states, the report card graded cities and counties around the nation. This additional analysis showed persistent racial, ethnic, and geographic disparities. According to the report card, Portland, Oregon has the best preterm birth rate at 7.2%, earning that city an “A” on the report card. However, Shreveport, Louisiana has the worst preterm birth rate and received an “F” for its 18.8% rate. Check out the grade for your state and the top 100 cities with the most births nationwide.

The March of Dimes has set a new goal to lower the national preterm birth rate to 8.1% by 2020 and to 5.5% by 2030. Reaching the 2020 goal of 8.1% will mean that 210,000 fewer babies will be born preterm and achieving the 2030 goal will mean 1.3 million fewer babies will be born preterm saving about $70 billion.

“This aggressive goal can be achieved by increasing best practices in preconception and pregnancy care, wider use of proven interventions such as progesterone and birth spacing, and funding discovery research through our research centers,” says Dr. Jennifer L. Howse, president of the March of Dimes.

Continued research to identify new medical advances to prevent preterm birth is necessary in order to reach the new goal. The March of Dimes supports a nationwide network of five cutting-edge, team-based research centers seeking to find the unknown causes of preterm birth and ways to prevent it.

November is Prematurity Awareness Month and World Prematurity Day (WPD) will be observed today (November 17) by the March of Dimes and partner organizations worldwide. Activities in honor of WPD are expected in about 100 countries. Join us for Twitter chats throughout the month and the 24-hour #worldprematurityday Buzzday today.

Tags: 2015 report card, march of dimes, Premature Birth Report Card, prematurity awareness month, Prematurity Research Centers, World Prematurity Day

Caring for yourself as you care for your preemie

Getting through a pregnancy, having a baby in the NICU, and caring for a baby with special needs at home can take a physical and emotional toll on a woman’s health. This month is a good time to remember to take care of yourself, so that you are in top form to take care of your family. Not only is November Prematurity Awareness Month, it is also National Caregivers Month.

By nature, moms tend to be wired to care for their babies. The daily routine (which goes well into the night) seems to blend into the next day and week. The 24/7 job of being a mom can often feel like a blur. Have you ever asked yourself what day it was only to be surprised when you learned that it was only Tuesday? Weekends, in the sense that most people think of them – free time, sleeping late, etc. – don’t exist. In fact, a Saturday feels much like a Tuesday in the new-mom world. It consists of the same routine: feedings, diaper changes, and caring for the special needs of your preemie.

It is not surprising then, that many moms experience exhaustion and burnout. Who wouldn’t? Every human being needs rest. Constant stress coupled with loss of sleep is a recipe for a downward spiral.

Just as moms care for others, they must learn to care for themselves. Unless you were really good at doing this before your baby was born, it may take a bit of practice. Carving out bits of time to care for yourself should be top on your list. I like to call it using “snippets of time.” Here are some examples:

• Got five minutes? Give your best friend a call. Just hearing her voice for a few minutes will give you a lift.
• Ten minutes may not seem like a long time to you, but that is how long it takes to take a shower and feel refreshed. You don’t need to plan a long chunk of time to do that – seize it whenever you have someone you trust watching your baby.
• Got 30 minutes alone? A walk or yoga video will help to create the energy you didn’t know you had. (Yes, exercise creates energy.)
• Too tired to walk? Try a quick nap (best done when your baby is also sleeping). Even 15 minutes will feel like you have been turbo charged.
• Schedule time with your spouse. Somehow, if it isn’t scheduled, it isn’t as likely to happen. If it is on the calendar, it is much more apt to become a reality. After all, if you went through the trouble to make sure someone you trust is watching your baby, then you will probably be sure you spend time together. But, again, it doesn’t have to be for hours. Even one hour out together will help to break up the 24/7 routine and give you a fresh perspective.

Somehow, your preemie caretaking will not seem so overwhelming when you get little breaks. Here are a few more ideas to help you.

How do you take care of yourself? Please share your tips.

Have questions?  Send them to AskUs@marchofdimes.org.

 

Tags: caretaker, caring for a preemie, stress, time management

SIGNATURE CHEFS AUCTION - WASHINGTON, D.C.

An evening of culinary excellence
Signature Chefs Auction - Washington, D.C.

 

DATE: Tuesday, November 17, 2015  |  Time: 6:30 PM
LOCATION: Ritz-Carlton, Washington, D.C. Hotel
ADDRESS: 1150 22nd Street, NW, Washington, DC 20037

For more information please contact Nicole Dolan (571)-257-2307.

PURCHASE TICKETS NOW

CAN'T JOIN US? Help fund the mission.

EVENT DETAILS

Chris Mullins, President and CEO of UnitedHealthcare of the Mid-Atlantic, and Mark Lowham, Managing Partner of TTR Sotheby's International, cordially invite you to the March of Dimes 19th Annual Signature Chefs Gala of Washington, D.C. Signature Chefs is one of D.C.'s premier social events highlighting the city's culinary masters brought together for an elegant evening of wine, cocktails and dining. You or your company can join approximately 500 affluent society members and business professionals as they support our mission while enjoying over 40 of the area's  celebrated chefs, mixologists, bartenders and vintners. What could be sweeter? The evening will also include auctions with unique dining, entertainment, travel and leisure packages.

Other Washington Notables include 2015 Honorary Chef Victon Albisu, chef/owner Del Campo and Taco Bamba, and 2015 Emcee Leon Harris, ABC7/WJLA-TV.

Photo Credit Greg Powers