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Your Baby

Pregnant? Exercise is Good For You!

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For years, the prevailing thought has been – if you didn’t exercise before, during pregnancy wasn’t the time to start. That’s no longer the case says, Alejandro Lucia, a professor of exercise physiology at the European University of Madrid.

A group of researchers want women to know that when it comes to exercise, there is a strong consensus of benefit for both the mother and developing fetus.

"Within reason, with adequate cautions, it's important for [everyone] to get over this fear," said Lucia.

According to the American College of Obstetricians and Gynecologists (ACOG), which updated its recommendations in 2015, women without major medical or obstetric complications should get at least 20 to 30 minutes of moderate-intensity aerobic exercise — enough to get you moving, while still being able to carry on a conversation — on most days of the week.

Lucia noted that evidence now suggests that starting an exercise program while pregnant can provide health benefits to both the mother and the growing fetus. Obviously, though, if you're new to exercise, take it slowly — you can work up to that 20 or 30 minutes.

The authors of the study say physical activity can prevent excessive weight gain, which can complicate the pregnancy and contribute to obesity. A review of existing research published in 2015 by the Cochrane Library found "high-quality evidence" that exercise during pregnancy can help prevent gaining too much weight, and may possibly lower the likelihood of a cesarean section, breathing problems in newborns, maternal hypertension and a baby that is significantly bigger than average. And of course, exercise promotes general cardiovascular and muscular health.

Other health problems can be helped such as chronic high blood pressure, gestational diabetes and women who are overweight or obese. Researchers say women with these conditions should be encouraged to exercise.

However, there are some health conditions in pregnancy where exercise should be avoided. According to the ACOG guidelines, women should avoid aerobic exercise if they have significant heart disease, persistent bleeding in the second or third trimester, severe anemia and risk of premature labor, among other conditions. And certain symptoms, such as contractions or dizziness during exercise, should be checked out quickly.

The bottom line is that women need to make a plan with their physician, taking into account their exercise history, their health, and the risk of pregnancy complications, says James Pivarnik, a professor of kinesiology and epidemiology at Michigan State University. He wasn't an author of the viewpoint but has conducted research on exercise and pregnancy.

Moderation is the goal during any exercise program. Long distance running and heavy weight lifting are not recommended. ACOG also recommends against contact sports, hot yoga, and exercises done in the supine position, i.e. lying face up, starting in the second trimester.

There are always exceptions to the rule, particularly with women who are highly trained athletes before they become pregnant. These women should still form plan with their OB/GYN on how much and what kinds of exercises are safe for them.

Among the general population and pregnant women specifically, people will respond differently to an exercise program. "But we know if you do the kind of things they're talking about here, the odds are your risk will be lower," says. Pivarnik.

Story source: Katherine Hobson, http://www.npr.org/sections/health-shots/2017/03/21/520951610/exercising-while-pregnant-is-almost-always-a-good-idea

Your Baby

Moms-to-be Need Folic Acid

1.45 to read

One of the best ways to have a healthy baby is to take good care of your own health.  Folic acid has been shown to help prevent certain birth defects, but now a new study suggests when a woman takes it in the first two months of pregnancy; her child may be less likely to have severe language delays.

Folic acid is a B vitamin (B9) found mostly in leafy green vegetables like kale and spinach, orange juice, and enriched grains.  It’s also available as a supplement.

American companies often add folic acid to their grains to help make sure that pregnant women are getting enough of the B vitamin.

“We don’t think people should change their behavior based on these findings,” said Dr. Ezra Susser from Columbia University’s Mailman School of Public Health in New York, who worked on the study.

“But it does add weight to the public health recommendation to take folic acid early in pregnancy,” he told Reuters Health.

And, he added, it shows that “what you do during pregnancy… is not only important for birth but also for subsequent development".

The study took place in Norway, where 40,000 women – a few months into their pregnancy- were surveyed on what supplements they were taking in the four weeks before they got pregnant and eight weeks after conception.

When their children were three years old, Susser and his colleagues asked the same women about their kids’ language skills, including how many words they could string together in a phrase.

Toddlers who could only say one word at a time or who had “unintelligible utterances” were considered to have severe language delay. In total, about one in 200 kids fit into that category.

Four out of 1,000 kids born to women who took folic acid alone or combined with other vitamins had severe language delays. That compared to nine out of 1,000 kids whose moms didn’t take folic acid before and during early pregnancy.

The pattern remained after Susser’s team took into account other factors that were linked to both folic acid supplementation and language skills, such as a mom’s weight and education, and whether or not she was married.

The study can’t prove that folic acid, itself, prevents language delay, they wrote in the Journal of the American Medical Association. But Susser said the vitamin is known to affect the growth of neurons and could influence how proteins are made from certain genes.

“The recommendation worldwide is that women should be on folate (folic acid) supplements through all their reproductive years,” Susser said.

The Centers for Disease Control and Prevention (CDC) recommends that all women of childbearing age — and especially those who are planning a pregnancy — consume about 400 micrograms (0.4 milligrams) of folic acid every day. Adequate folic acid intake is very important before conception and at least 3 months afterward to potentially reduce the risk of having a fetus with a neural tube defect.

You can boost your intake by looking for breakfast cereals, breads, pastas, and rice containing 100% of the recommended daily folic acid allowance. But for most women, eating fortified foods isn’t enough. To reach the recommended daily level, you’ll probably need a vitamin supplement.

Your Baby

Acetaminophen Ranks Highest in Infants’ Accidental Poisonings

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Infants are just as susceptible to accidental poisonings as toddlers and older children, according to a new study. Acetaminophen (such as Tylenol) was the most common medication error for infants. Some of the other products associated with accidental poisonings may surprise you.

The researchers look at data from all poison control center calls in a national database from 2004 to 2013 that related to babies younger than 6 months old.

Acetaminophen was the most reported medication mistake followed by H2-blockers (for acid reflux), gastrointestinal medications, combination cough / cold products, antibiotics and ibuprofen (such as Motrin or Advil).

The most common non-medication exposures were diaper care and rash products, plants and creams, lotions and make-up, the investigators found.

"I was surprised with the large number of exposures even in this young age group," said lead author Dr. A. Min Kang, a medical toxicology fellow at Banner-University Medical Center Phoenix in Arizona.

"Pediatricians typically do not begin poison prevention education until about 6 months of age, since the traditional hazard we think about is the exploratory ingestion -- that is when kids begin to explore their environment and get into things they are not supposed to," Kang added.

The research team found that there were more than 270,000 exposures reported during the decade of data, 97 percent of which were unintentional. However, over 37 percent were related to medication mistakes.

Acetaminophen was involved in more than 22,000 medication exposures and nearly 5,000 general exposures. This high rate reflects its frequent use because it's recommended instead of ibuprofen for infants, Kang pointed out.

"The concern with too much acetaminophen is liver failure although, luckily, young children are considered to be somewhat less likely to experience this than an adult because the metabolism is a little different," Kang said.

The current rate of acetaminophen mistakes may actually be lower notes Dr. Michael Cater, a pediatrician with St. Joseph Hospital in Orange, California, because infant drops are now standardized across manufacturers.

The number of ibuprofen exposures, however, surprised Cater since ibuprofen isn't recommended for those under 6 months old.

"Also surprising was the number of ethanol poisonings," likely from parents leaving empty glasses or bottles of alcohol around, he said. "Low-lying plants, some of which are toxic, are a source of concern, and this was a bit of a surprise to me."

Diaper creams and lotions likely top the list because they're easily reachable by infants when left on the diaper-changing areas, Cater added.

The AAP has a policy statement recommending that all liquid medications use metric units for dosing and that they include administration devices, such as syringes, to reduce the chance of an overdose.

Perhaps doctors should offer poison prevention education to caregivers earlier, even starting when a baby leaves the hospital, Kang suggested.

The poison control hotline phone number- 1-800-222-1222 – should also be posted in the home and programmed into parents and caregiver’s cell phones Kang said.

The findings were published online in the January edition of the journal Pediatrics, and in the February print edition.

Source: Tara Haelle, http://www.webmd.com/children/news/20160113/acetaminophen-tops-list-of-accidental-infant-poisonings

Your Baby

FDA Warning: No Homeopathic Teething Tablets or Gels

1:45

Some babies have little to no symptoms during teething, while others experience quite a bit of pain for months. When teething pain occurs, infants may cry and be irritable until they find relief.

Homeopathic tablets and gels aimed at helping soothe babies’ pain may be dangerous for infants and toddlers, the Food and Drug Administration (FDA) recently announced in a statement. 

The FDA is investigating reports of seizures in infants and small children who were given homeopathic teething products, which may contain "natural" compounds but are not regulated as drugs by the FDA.

In addition, the FDA said in the statement that "consumers should seek medical care immediately if their child experiences seizures, difficulty breathing, lethargy, excessive sleepiness, muscle weakness, skin flushing, constipation, difficulty urinating or agitation" after using homeopathic teething tablets and gels.

According to the National Center for Complimentary and Integrated Health, homeopathy relies on two theories: “like cures like”—the notion that a disease can be cured by a substance that produces similar symptoms in healthy people; and “law of minimum dose”—the notion that the lower the dose of the medication, the greater its effectiveness.

The FDA said in the statement that the agency is not aware of any proven health benefit of using homeopathic teething tablets and gels.

In 2010, the FDA issued a safety alert about a homeopathic teething tablet that contained belladonna. Belladonna — also called deadly nightshade — is a poisonous plant that contains a chemical called atropine. At high levels, atropine can be deadly. In homeopathy, it is used to treat redness and inflammation.

At the time, the FDA found that the teething tablets contained inconsistent amounts of belladonna. The company that made the tablets, Hyland, subsequently recalled the product.

Hyland issued a statement and video in response to the current FDA warning against the use of homeopathic teething remedies.

"As you may have seen, on September 30, 2016, the Food and Drug Administration issued a surprise statement recommending that consumers discontinue use of homeopathic teething tablets and gels because they may pose a risk," Hyland's stated. "We are fully cooperating with FDA’s inquiry and we’re providing them with all the data we have. We also hope to learn from FDA what facts, if any, the Agency has based its action on."

Hyland also noted “The safety and effectiveness of Hyland’s natural homeopathic medicines is our top priority. That’s why we work with regulators to ensure that our products meet the highest standards. If we ever had reason to be concerned of that safety, we would act immediately."

"Teething can be managed without prescription or over-the-counter remedies," Dr. Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research, said in the FDA statement. 

The American Academy of Pediatrics (AAP) recommends teething rings or hard, unsweetened teething crackers. Do not use frozen teething toys because they can cause more discomfort by injuring a baby's mouth, the AAP advises.

Be sure and check with your pediatrician about teething pain relief if your little one is having a hard time getting through the teething process.

Story sources: Sara G. Miller, http://www.livescience.com/56352-fda-warning-homeopathic-teething-tablets.html

Michael Johnsen, http://www.drugstorenews.com/article/hylands-responds-fda-teething-tablet-warning

 

Your Baby

Britax Recalls Car Seat Chest Clips Due to Infant Choking Hazard

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Faulty chest clips on more than 100 models of Britax Care Safety car seats are being voluntarily recalled because the clips could break off and create a choking hazard for infants.

The company says that no injuries have been reported, but it has received complaints of chest clips breaking.

The recall will affect more than 200,000 car seats. However, Britax stresses that the car seats are still safe to use until a replacement kit is obtained. 

The chest clip is on the Britax B-Safe 35, B-Safe 35 Elite, and BOB B-Safe 35 infant seats.

The products were manufactured between Nov. 1, 2015, and May 31, 2017. To see the model numbers that are included in the voluntary recall, or to check the serial number of your seat, visit the company’s website set up for this recall at www.bsafe35clip.com. You can find the serial numbers on the "Date of Manufacture" label on the lower frame of the seat.

Britax is offering to replace the chest clip with a free kit that contains a new clip made from a different material. The kit comes with step-by-step instructions for replacement. Consumers are advised to routinely check their current chest clip until a replacement arrives.

Story sources: Alexandria McIntire, http://www.webmd.com/children/news/20170623/recall-britax-car-seat-chest-clip

Ashlee Kieler, https://consumerist.com/2017/06/21/britax-recalls-207000-carseats-over-chest-clips-that-can-break/

Your Baby

Delayed Cord Clamping May Improve Infant’s Health

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According to a new study, delaying umbilical cord cutting by 2 minutes after birth may result in better development in a newborn’s first days of life.

When to cut the umbilical cord has been debated and changed over a long period of time. Before studies began in the mid-1950s, cord clamping within 1 minute of birth was defined as "early clamping," and "late clamping" was defined as more than 5 minutes after birth. And the American Congress of Obstetricians and Gynecologists (ACOG) have stated, "the ideal timing for umbilical cord clamping has yet to be established."

To provide further evidence in the debate of early versus late cord clamping, researchers led by Professor Julio José Ochoa Herrera of the University of Granada, assessed newborn outcomes for infants born to 64 healthy pregnant women to determine the impact of clamping timing on oxidative stress and the inflammatory signal produced during delivery.

All of these women had a normal pregnancy and spontaneous vaginal delivery. However, half of the women's newborns had their umbilical cord cut 10 seconds after delivery and half had it cut after 2 minutes.

Results showed that with late cord clamping there was an increase in antioxidant volume and moderation of inflammatory effects in newborns.

Other studies have shown that delaying clamping allows more time for blood to move from the placenta through the cord, improving iron and hemoglobin levels in newborns.

If delaying cord clamping is beneficial for newborns, then why do many doctors perform a quick cut? Apparently there are several reasons.

According to ACOG, a previous series of studies into blood volume changes after birth concluded that in healthy term infants, more than 90% of blood volume was attained within the first few breaths he or she took after birth.

As a result of these findings, as well as a lack of other recommendations regarding optimal timing, the amount of time between birth and umbilical cord clamping was widely shortened; in most cases, cord clamping occurs within 15-20 seconds after birth.

The World Health Organization (WHO) believes waiting longer is better. WHO supports late cord clamping (1-3 minutes) because it "allows blood flow between the placenta and neonate to continue, which may improve iron status in the infant for up to 6 months after birth."

ACOG states on their website that “Concerns exist regarding universally adopting delayed umbilical cord clamping. Delay in umbilical cord clamping may jeopardize timely resuscitation efforts, if needed, especially in preterm infants. However, because the placenta continues to perform gas exchange after delivery, sick and preterm infants are likely to benefit most from additional blood volume derived from a delay in umbilical cord clamping.”

WHO states clearly that that early cord clamping - less than 1 minute after birth - is not advised unless the newborn is asphyxiated and needs to be moved for resuscitation.

Simply holding a wet, crying and wiggling baby for 2 minutes may also prove difficult for physicians whose hands are gloved. The better option may be to place the baby on the mother’s stomach, wait the 2 minutes and then cut the cord.

More and more studies are finding that in certain circumstances, waiting a couple of minutes longer to cut the umbilical cord may be best for baby.

According to this study, there’s really no reason why newborns from a normal pregnancy and vaginal delivery should not be allowed at least 2 minutes before the cord is clamped after birth.

Mothers and fathers-to-be should discuss cord cutting timing with their doctor before the baby is born. If your preference is to allow more time before cutting the cord when your baby arrives, let your physician know ahead of time.  He or she can then advise you on when early clamping may be necessary and when it can wait a couple of extra minutes.

Scientists from the University of Granada and the San Cecilio Clinical Hospital in Spain conducted the research. The results were published in the journal Pediatrics. Source: Marie Ellis, http://www.medicalnewstoday.com/articles/287041.php

http://www.acog.org

Your Baby

Gap Between Pregnancies Linked to Autism

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Does it make a difference how long a woman waits between pregnancies in the health of her newborn?  According to a new large study, the closer the pregnancies, the higher the risk that her child will have autism or other neurodevelopmental disabilities.

"Based on the current best available evidence, it appears that the ideal inter-pregnancy interval -- the time elapsed between the birth of the immediate older sibling and the conception of the younger sibling -- is 2 to 5 years, in order to reduce the risk of autism," said study author Dr. Agustin Conde-Agudelo. He is a researcher at the World Health Organization Collaborating Center in Human Reproduction at the University of Valle in Cali, Colombia.

Researchers looked at existing studies involving more than 1.1 million children and also found that waiting too long between pregnancies (5 years or more) could raise the odds of autism.

The reasons for the link between short pregnancy spacing and autism are not known noted Conde-Agudelo. He said that scientists believe nutrition and other factors may play a role.

The study doesn’t prove that either long or short intervals between pregnancies actually causes autism, just that there seems to be an association between the two.

Conde-Agudelo and his team reviewed seven large studies reporting a link between short birth spacing and autism. The investigators found that children born to women with less than 12 months between pregnancies were nearly twice as likely to develop autism as children born to women with three years or longer between pregnancies.

Three of those studies also reported a significant link between long pregnancy spacing and autism, especially for two milder types, which were formerly called Asperger's syndrome and pervasive developmental disorder.

Meanwhile, the findings also suggested that shorter pregnancy spacing was associated with an increased risk of developmental delays and cerebral palsy, which can affect body movement, muscle coordination and balance.

Conde-Agudelo and other researchers conjectured that the mother’s depleted levels of folic acid between closely spaced pregnancies might play a role in the rise of autism risk.

The B vitamin folic acid is necessary for proper brain and spinal cord development in fetuses, and women are typically advised to take folic acid supplements during pregnancy.

As for longer pregnancy intervals also potentially linked to autism, Conde-Agudelo said it's been hypothesized that related factors such as infertility, unintended pregnancy and maternal inflammation levels may affect autism possibility.

Most neurodevelopmental disabilities, including autism, are thought to be caused by a complex mix of factors. These include genetics, environment, parental health and behaviors during pregnancy, and complications during birth, the researchers said in background notes.

The study was published in the April online edition of the journal Pediatrics, and will appear in the May print issue.

Story source: Maureen Salamon,  http://consumer.healthday.com/cognitive-health-information-26/autism-news-51/pregnancies-close-together-may-raise-autism-risk-study-says-709733.html

Your Baby

Babies May Never Outgrow Their Native Language

1:30

How early are babies able to learn their native language? According to a new study from South Korea, as early as the first few months of life.

The study takes an interesting look at the impression that language makes on newborns and whether babies actually retain any birth language ability even if they are adopted and grow up in a different country.

For this study, adults that were adopted from South Korea as babies by Dutch-speaking families were asked to pronounce Korean consonants after a short training course.

Researchers found that the now Dutch-speaking adults exceeded expectations at Korean pronunciation when retrained after losing their birth language.

The two languages have little in common. Korean consonants are unlike those spoken in Dutch.

The participants were compared with a group of adults who had not been exposed to the Korean language as children and then rated by native Korean speakers.

Both groups performed to the same level before training, but after training the international adoptees exceeded expectations.

There was no difference between children who were adopted under six months of age - before they could speak - and those who were adopted after 17 months, when they had learned to talk.

Because of the young ages of the adopted children, researchers suggested the language knowledge retained is more abstract in nature, rather than dependent on experience.

Dr Jiyoun Choi of Hanyang University in Seoul led the research.

The study is the first to show that early experiences of adopted children in their birth language, continues to give them an advantage decades later, even if they think it is forgotten, she said.

Other studies suggest that babies may learn their natural language as early as in the womb. Typically, babies begin uttering vowel sounds at about 6 weeks, but won’t be able to make words - associated with meanings - until around 12 to 16 months of age.  How early a child learns to speak is dependent on factors such as, how much parents, siblings or relatives interact and talk to them, along with good hearing and health.

''Please remember that [the] language learning process occurs very early in life, and useful language knowledge is laid down in the very early months of life as our study suggests,'' Choi said.

''Try to talk to your babies as much as possible because they are absorbing and digesting what you are saying.''

Talking to and positive interaction with your baby not only helps him or her learn language quicker, but also builds a foundation for feeling safe and valued as a unique and important member of the family. 

Story source: Helen Briggs, http://www.bbc.com/news/science-environment-38653906

Your Baby

Pregnancy: Too Much, Too Little Weight Gain Adds to Health Risks

2:30

If you’re thinking about becoming pregnant, starting your pregnancy at a normal weight is best for baby and you, according to new study.

The study found that too much or even too little weight, increases an expectant mom's risk for severe illnesses and death. 

"Not only for baby's sake, but also for your own sake, have a healthy diet and get regular exercise before pregnancy," said study lead author Dr. Sarka Lisonkova. She's an assistant professor in the department of obstetrics and gynecology at the University of British Columbia and the Children's and Women's Health Centre in Vancouver. 

"It's never too late, even if you're already pregnant," Lisonkova said, adding that weight gain during pregnancy can also increase the risk for severe illnesses and even death in expectant mothers.

The study was large, including information on three-quarter of a million women. The average age of the women was 28 years old.

The researchers found that the more a woman weighed, the more likely she was to have a severe illness or to die during pregnancy. Underweight women also had an increased risk for these outcomes. Severe illness included such conditions as eclampsia (convulsions or coma brought on by high blood pressure), sudden kidney failure, sepsis, hemorrhage and respiratory problems.

While the results sound scary, the risk to any one particular woman is low. For instance, the study found that, compared with normal-weight pregnant women, there were about 25 more cases of either severe illness or death for every 10,000 pregnant women if the woman was obese.

"The chance that any one woman dies in pregnancy is about 1 in 6,000 in the United States," said Dr. Aaron Caughey, who chairs the department of obstetrics and gynecology at Oregon Health and Science University in Portland

However, what's especially concerning about this study's findings, he said, is that more and more women are entering pregnancy obese or super-obese. With higher levels of obesity, "there's an incredibly high inflammatory state that increases the risk of rare outcomes, like thromboembolism," a blood clot, Caughey said.

He said that underweight women likely had a chronic illness that increased their risk. 

Both Caughey and Lisonkova said that ideally, women should be at a normal weight before getting pregnant. If a woman isn't at her ideal weight, pregnancy is a good time to start focusing on things such as eating a healthy diet and getting regular exercise, they said. 

Pregnancy can be a "focusing event for affecting behavior change in women," Caughey said, because once pregnant, a woman often focuses on doing what she can to have a healthy baby.

"Pregnancy is a great time to think about diet and exercise, especially because women often drive health behaviors in the family, so there's no time like the present to make healthy changes," he said. 

Lisonkova also emphasized the importance of good prenatal care. "Clinicians can catch signs of potential complications earlier with regular checkups," she said. 

A woman will naturally gain weight while pregnant and that’s as it should be, but if you begin a pregnancy overweight it’s more difficult to keep the weight gain within the normal range. It’s healthier for mom and baby to begin a pregnancy at or close to a normal weight.

The study was published in the November edition of Journal of the American Medical Association.

Story source: Serena Gordon, https://consumer.healthday.com/vitamins-and-nutrition-information-27/overweight-and-underweight-health-news-516/weighing-too-much-or-too-little-when-pregnant-can-be-risky-728505.html

 

 

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