Silent but dangerous bacteria

About 25% of pregnant women carry Group B streptococcus (also called Group B step or GBS). GBS may come and go quietly in your body without any symptoms, so you may not be aware that you are carrying it. GBS may never make you sick and we don’t know exactly how the bacteria is transmitted. But while GBS may not be harmful to you, it can be very harmful to your baby.

How can GBS affect you during pregnancy?

GBS lives in the rectum or vagina and can cause a bladder or urinary infection (UTI). Women who have symptoms can receive antibiotics from their provider. If you don’t have symptoms of an infection, you may not know you need treatment. Without treatment, a uterine infection during pregnancy can increase your chances of:

• Premature rupture of the members – When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts
• Preterm labor – Labor that happens too early, before 37 weeks of pregnancy
• Stillbirth – When a baby dies in the womb before birth, but after 20 weeks of pregnancy

Is there any good news?

Yes, you can be tested for GBS. If you are pregnant, you will be tested for GBS at 35 to 37 weeks of pregnancy. Your provider will take a swab of your vagina and rectum and the sample will be sent to the lab. The process is simple and painless and results will be available in 1 to 2 days. If you go into preterm labor, your provider can use a quick screening test during labor to test you for GBS.

If the test is positive:

You will receive an antibiotic from your provider during labor and birth through an IV, which helps prevent your baby from getting the infection. Remind your health care provider at the hospital when you go to have your baby; this way you can be treated quickly. It may be helpful to make a note and stick it on top of your hospital bag so you remember as you walk out the door. If you have GBS and a scheduled cesarean birth (C-section) before labor starts and before your water breaks, you probably don’t need antibiotics.

With treatment, a woman has only a 1 in 4,000 chance of delivering a baby with group B strep, compared to a 1 in 200 chance if she does not get antibiotics during labor.

If you are worried about GBS, speak with your health care provider. Have questions? We are here; email AskUs@marchofdimes.org.

Tags: bladder infection, GBS, Group B strep, Group B streptococcus, urinary infection, uterine infection, UTI

Banking your baby’s umbilical cord blood–should you do it?

The umbilical cord connects your baby to the placenta. Umbilical cord blood contains stem cells, which may be used to treat certain diseases. Because of this, many people consider storing or banking the cord blood so that it may possibly be used in the future.

What are stem cells?

Stem cells can grow into specific kinds of cells in your body and may be used to treat some diseases, like cancer. In healthy people, bone marrow makes stem cells. But sometimes a person’s bone marrow stops working and doesn’t make enough healthy stem cells. For people with conditions like cancer, treatments like chemotherapy or radiation can kill healthy stem cells.

If a person needs new stem cells, he may be able to get a stem cell transplant from cord blood. New stem cells from the transplant can go on to make new, healthy cells.

Storing cord blood

There are two options for storing cord blood:

Public cord blood bank: This option is appropriate for most families and is recommended by the American Academy of Pediatrics (AAP). Cord blood donation is used for research or to help others. There’s no cost to you to donate. If you or a family member ever needs cord blood, you can’t use the blood you donated, but you may be able to use cord blood donated by others. Several cord blood banks participate in this program.

Private cord blood bank: This may be a good option for you if you have a child or family with a health condition that may need to be treated with a stem cell transplant. Depending on the bank you choose, the cost is about $2,000, plus a yearly fee of about $125. The chance that your baby or a family member may need to use your stored cord blood is very low – about 1 in 2,700.

Planning for cord blood collection

If you decide to store your baby’s cord blood (through either a public or private bank), you will need to plan ahead of time and make sure your provider is aware of your choice. Between your 28th and 34th week of pregnancy, talk to your provider about your decisions and learn if you meet the donation guidelines.  Put your decision about cord blood on your birth plan. The March of Dimes birth plan includes a question about storing umbilical cord blood.

Your provider usually uses a collection kit that you order from the cord blood bank. To collect the cord blood, your provider clamps the umbilical cord on one side and uses a needle to draw out the blood. The blood is collected in a bag and then sent to the cord blood bank. Your provider can collect cord blood if you have either a vaginal delivery or a C-section.

According to Be the Match, each year in the United States, more than 10,000 people are diagnosed with life-threatening diseases that may be treated with a stem cell transplant. When a patient with leukemia, lymphoma or other life-threatening disease needs a transplant, cord blood may be an option. Today, 15% of transplant patients receive cord blood that was generously donated to a public cord blood bank.

Questions? Email us at AskUs@marchofdimes.org.
Tags: cord blood, cord blood bank, storing cord blood, umbilical cord

Cinemama” App Helps Moms Track Weight Gain During Pregnancy

Gaining too much or too little weight during pregnancy can have serious health consequences for your baby. The updated March of Dimes CineMama app helps moms-to-be track their weight gain as well as make a time-lapse movie of their pregnancy. The app is free and available for both iOS and android devices.

The “CineMama” app debuted in 2013 enabling women to create a time-lapse video of their pregnancy while getting health tips along the way, and to date, more than 120,000 women have downloaded it. Now, the app has added a pregnancy weight tracker to help women know whether they are gaining a healthy amount of weight during their pregnancy. The pregnancy weight tracker is provided through a grant from the Institute of Medicine (IOM) and based on the scientific findings from a 2009 IOM report that determined guidelines for healthy weight gain during pregnancy.

Women who gain too little are more likely to have a low birthweight baby (less than 5 pounds, 8 ounces). Women who gain too much are more likely to have a premature baby, who is at risk for breathing problems, jaundice, and intellectual delays. Excessive weight gain also may contribute to conditions, like diabetes and high blood pressure, which can cause problems during pregnancy.

“Many women think they can double the amount of calories they eat once they are pregnant,” says Siobhan Dolan, MD, a medical advisor to the March of Dimes. “But the reality is they only need an extra 300 calories a day - that’s one extra healthy snack a day.”

CineMama is part of the March of Dimes “Healthy Babies are Worth the Wait” educational campaign, which focuses on the importance of a full term pregnancy. The campaign encourages women to wait for labor to begin on its own and reminds health care providers to not schedule a delivery before at least 39 weeks of pregnancy, unless there is a medical necessity. Important development of the brain, lungs and other organs occurs during the last weeks of pregnancy. Additional information is available at marchofdimes.org/39weeks.

About March of Dimes
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.

Preventing cleft lip and palate defects

I remember seeing a thin scar on my friend’s upper lip, and wondered how she had gotten it. “I was born with a cleft lip,” she said. I became curious about her cleft lip and how it turned into one tiny scar.

A cleft lip is a type of craniofacial abnormality. These are birth defects of the head (cranio) and face (facial) that are present when a baby is born. Another common type is a cleft palate. As July is National Cleft and Craniofacial Awareness and Prevention Month, it is a good time to learn more about these birth defects.

How does a cleft lip or palate form?

The lips of a baby form by about 6 weeks of pregnancy. When the lip doesn’t form completely and is left with an opening, this is called a cleft lip. A baby’s palate (the roof of her mouth) is formed by about 10 weeks of pregnancy. When the palate doesn’t form completely and has an opening, it’s called a cleft palate. A baby can be born with just one of these abnormalities or with both.

Each year in the U.S., about 2,650 babies are born with a cleft palate and 4,440 babies are born with a cleft lip with or without a cleft palate. The causes of clefts with no other major birth defects among most infants are unknown.

In most cases, cleft lip and cleft palate can be repaired by surgery. Each baby is unique, but surgery to repair cleft lip usually is done at 10 to 12 weeks of age. Surgery for cleft palate usually is done between 9 and 18 months of age. A child may also need more surgery for his clefts as he grows.

My friend had corrective surgery to repair her lip when she was still a baby. Now all that is left is one thin scar above her upper lip leading to her nose, which you can hardly see.

Can these birth defects be prevented?

There are steps a pregnant woman can take to decrease her chance of having a baby with a cleft lip or palate.

• 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.org.

Tags: birth defect, cleft lip, cleft palate, craniofacial abnormality, craniofacial defect

Living with loss

For families that suffer from the unspeakable pain of losing a baby, their grief continues for a lifetime. It may ebb and flow; it may be more acute at anniversaries or when something triggers a memory. It may even seem to be out of mind for periods of time, but it is never gone completely. A woman starts loving her baby from the moment of conception and this love continues throughout her entire life. Similarly, the feelings of sadness and loss continue because a parent’s love has no end.

At the March of Dimes, women have written to us after suffering a miscarriage or stillbirth, asking when they will “get over” the loss of their baby. This is a question that is impossible to answer. Your life will go on – all the chores, jobs, responsibilities and even parties continue. But, the reminders will be there always, with the sadness and deep disappointment to go along with it.

I know a woman who lost her baby boy 31 years ago. She had tried for years to become pregnant, so her pregnancy was an especially joyous time for her. The immense happiness was followed by intense grief on the day of her son’s birth, as he lived for only a few hours. Even though she eventually went on to have a healthy baby, she still mourns the loss of her son. She marks her son’s birth and death every year, and continues to remember him. Her pain is palpable, even though so many years have gone by since that heartbreaking time.

Acknowledging and talking about the loss of her baby has helped her to know that her son was real, and that her grief is legitimate. She had bonded with her baby from the moment she learned she was pregnant. To ask her to forget about this tiny person would be ridiculous.

The pain of losing a baby is one that many women struggle with for life. Perhaps it is because the baby never got the chance to grow up and follow his dreams. Or, maybe it is because the mom is denied the natural desire to nurture her child and watch him grow up. Losing a child is like a double wallop- you lose your child and the dreams that go along with him.

It’s so unfair.

If you have suffered a pregnancy or infant loss, you may want to reach out to others who will understand your unique pain. You may find a local support group in your area, or you can join our online community, Share Your Story where you will meet other women who know what living with loss is all about. You are not alone.

The March of Dimes has written a booklet called From Hurt to Healing to help families understand their grief. It explains grief and how men and women grieve differently. It talks about how to deal with your feelings, tells you how to ask for help, how to deal with family and friends, how to help other children understand. And it suggests ways to remember your baby. Two other booklets, What Can You Do? and When You Want to Try Again are part of a packet the March of Dimes offers free to bereaved parents who have suffered a loss. If you would like to receive a packet, send your name and address to AskUs@marchofdimes.org.

You will never forget your baby, but in time the power of love will help you find the strength to move forward and love again.

 

Comments or questions? Send them to AskUs@machofdimes.org.

View posts in the series on Delays and Disabilities: How to get help for your child.

 

Tags: grief, infant loss, loss, miscarriage, neonatal loss, stillbirth

Breastfeeding on demand vs. on a schedule

We often receive questions from new moms asking when they should start their newborn’s next feeding. If they breastfed their baby at 2pm, they wonder if they should wait to feed their baby until 5pm. The golden rule is to feed your baby when she’s hungry, called “on-demand” feeding. It is more important to watch your baby for cues that she’s hungry rather than worry about the timing of her feeding.

If you have ever gone to a party, the hostess usually will offer you food or a drink without first asking “are you hungry?” She offers you the food and then you can decide if you want to eat. The same should go for your baby. If she seems unsettled, try breastfeeding. If she is hungry and feeds, you made a good guess; but if not, then you know you can try to settle her in another way (rocking, walking, etc.)

Newborns may eat between 8 and 12 times over 24 hours, which is about once every 2 to 3 hours. If that seems like a lot, it is! Feedings may last about 15-30 minutes. But each baby is different and your baby may need to feed more often or for longer amounts of time.

Will you have enough milk for all these feedings?

The amount of milk a woman can produce and store varies greatly and is not determined by the size of her breasts. As your baby sucks on your nipple, she stimulates your hormones to send a message to your brain telling your body to produce milk. Your hormones, along with your baby’s suckling causes your breasts to “letdown” and provides the milk to your baby’s mouth. Letdown may also occur when you think about your baby, or hear her or even another baby cry.

The more often you nurse, the more milk your body will produce. Your milk production will slow between feedings when milk accumulates in your breast and will speed up when the breast is emptier. Your body is producing milk all the time, the only thing that changes is the speed of production. Your breasts do not need to feel “full” in order to produce enough milk for your baby. The key to breastfeeding on demand is to feed your baby when she wants for as long as she wants. Ignore the clock!

Still not convinced? Here’s the science behind milk production

Your body produces two hormones, prolactin and oxytocin. The hormone prolactin tells your body to use its proteins, sugars and fat from your blood supply to make breast milk. The oxytocin tells your body’s muscles to contract and push the milk into your ductal system and into your nipple as your baby sucks. As your baby continues to suck, your body releases more prolactin which triggers your body to make more breast milk. Between feedings your body’s prolactin levels off, but once you start feeding again, your milk production restarts. So, if you want to produce more milk, you will need to breastfeed or pump more often.

Tips to keep in mind

• If your baby feeds more often than every two hours, it does not mean there is a supply problem.
• For most babies, breast milk is easier to digest than formula. This is why a breastfed baby may feed more often than a formula fed baby.
• You do not need to wait for your breast to ‘refill’ before your baby’s next feeding.
• Certain factors can affect your letdown reflex such as being tired, being stressed or having pain in your breast. Seek support when you need it. 
• Read about common breastfeeding myths in Breastfeeding myths debunked -part 1 and part 2.
• Remember, any breast milk you provide your baby is beneficial. It’s important to find the methods and solutions that work best for you and your baby.

Worried if your baby is getting enough to eat? Visit our page.

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

Tags: breast milk, breastfeeding, breastfeeding myths, letdown reflex, milk production, on-demand, on-demand breastfeeding, on-demand feeding

Screening vs. diagnostic testing—what’s the difference?

If you are pregnant, you know that every visit to your prenatal care provider involves a number of tests. At each prenatal checkup, your provider checks your weight, blood and urine. But in addition to these routine tests, you will also be offered prenatal tests that can assess your risk to have a baby with certain birth defects.

The American College of Obstetricians and Gynecologists (ACOG) recommends that all pregnant women, regardless of age, be offered prenatal testing for Down syndrome and some other birth defects. There are two different types of tests that you can have: a screening test or a diagnostic test. It’s important to understand the difference between a screening test and a diagnostic test. Screening tests help evaluate the risk for certain birth defects, but they cannot diagnose a birth defect. Screening tests pose no risk to mother or baby. Diagnostic tests are highly accurate at diagnosing or ruling out specific birth defects. However, these tests may pose a very small risk of miscarriage.

Screening tests offered during pregnancy include:

• Cell-free fetal DNA testing (also called noninvasive prenatal screening or testing): Some of your baby’s cells can be found in your blood. This test uses a sample of your blood to look at your baby’s DNA to check for certain genetic conditions. You can have this test after 10 weeks of pregnancy. This test is not recommended for women who aren’t likely to have a baby with a birth defect or who are pregnant with multiples.
• First-trimester screening: Using a blood sample and ultrasound measurements, first-trimester screening can tell you if your baby is at risk for some birth defects, like Down syndrome. It is usually done between 11 to 13 weeks of pregnancy.
• Maternal blood screening: This test measures four substances in your blood to determine the chance that a woman has a baby with certain birth defects like Down syndrome and neural tube defects. The test is done between 15 to 20 weeks of pregnancy.

Diagnostic tests are done by obtaining samples of your baby’s actual cells and therefore are more invasive. Diagnostic testing can detect most birth defects caused by a change in the number or shape of chromosomes. And testing for many inherited disorders can be done as well. However, not all birth defects can be detected.

Some women may choose to have diagnostic testing done instead of screening tests based on their age or family history. Other women may choose to start with a screening test and then, depending on the results, decide whether to have a diagnostic test. Prenatal diagnostic tests do carry a small risk of miscarriage (about 1 in 300-500).

• Chorionic villus sampling (also called CVS): During this procedure, the doctor removes a small sample of tissue from the placenta. This can either be done transvaginally or transabdominally. You can get CVS at 10 to 12 weeks of pregnancy.
• Amniocentesis (also called amnio): Your health care provider will use a needle to remove a small amount of amniotic fluid. Amnio is done between 15 to20 weeks of pregnancy.

Remember, all of these tests are optional. Make sure that you discuss your questions and concerns with your health care provider.

Questions? Send them to AskUs@marchofdimes.org.

 

Tags: amniocentesis, birth defects, chorionic villus sampling, CVS, Down Syndrome, maternal blood screening, prenatal tests, ultrasound

Having a baby in the NICU can be stressful for siblings

Giving birth early and having a baby in the NICU is stressful for parents; but what is sometimes overlooked is how upsetting it is for the preemie’s siblings.

A change in routine is upsetting to children. Having mom and dad away from home for long periods of time can turn even the most well-adjusted child upside down. If your child has not been able to visit her sibling or she does not have a solid grasp on what is happening, the uncertainty of the situation can cause distress. What can you do to ease the anxiety that is trickling down to the smallest members of your family?

• Talk to your child at a level that she can understand. There are children’s books that explain prematurity. These books can make the explanation much easier for parents. Check with your local library for appropriate titles.
• Reassure your child that nothing she did or said caused her sibling to be born early. Some kids may blame themselves or feel guilty.
• Your child might be very worried and fear that the baby may never come home. As best you can, let your child know that you and the doctors and nurses are taking good care of her baby sibling, just as they would take care of her.
• Understand the signs of distress in your child. Any regression (loss) in developmental progress (such as bed wetting, not sleeping through the night, acting out or being excessively attached to you), may indicate that your child is feeling the negative effects of the situation.
• If possible, have your child visit your baby in the NICU.
• In the Preemies book, you can read about these and other ways to minimize the anxiety that having a baby in the hospital can have on your family.

Do you have any tips to share on how to help your older children got through the stress of having a baby sibling in the NICU? Please share.

Have questions? Send them to AskUs@marchofdimes.org

View other posts in the series on Delays and Disabilities: How to get help for your child.

 

Tags: behaviors, coping, delays, disabilities, NICU, prematurity, siblings, stress

This entry was posted on Wednesday, June 24th, 2015 at 2:48 pm and is filed under Help for your child, Prematurity, Uncategorized. 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.